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General NPI Number Information
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NPI Number | 1104078575
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Entity Type | Organization
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Legal Business Name | SOUTHWEST EYE CLINICS, P.A.
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 4355 INTERSTATE 30 STE 100
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City | MESQUITE
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State | TX
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Zip | 75150-2035
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Country | US
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Telephone | 214-501-5426
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Fax | 214-501-5425
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Provider Business Mailing Address
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Address Line | 4355 INTERSTATE 30 STE 101
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City | MESQUITE
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State | TX
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Zip | 75150-2061
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Country | US
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Telephone | 214-328-6000
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Fax | 214-328-1260
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. MAARIYA KHAN
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Credential |
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Telephone | 214-260-5020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | E1233
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License Number State | TX
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