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General NPI Number Information
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NPI Number | 1114110970
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Entity Type | Organization
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Legal Business Name | MESQUITE FAMILY OPTOMETRY
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Dates
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Enumeration Date | 08/23/2007
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Last Update Date | 08/23/2007
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Provider Practice Location Address
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Address Line | 820 E CARTWRIGHT RD SUITE 150
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City | MESQUITE
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State | TX
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Zip | 75149-6000
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Country | US
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Telephone | 972-288-2520
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Fax | 972-288-2236
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Provider Business Mailing Address
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Address Line | 820 E CARTWRIGHT RD SUITE 150
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City | MESQUITE
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State | TX
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Zip | 75149-6000
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Country | US
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Telephone | 972-288-2520
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Fax | 972-288-2236
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Authorized Official
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Title or Position | OWNER
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Name | RONALD K SMITH
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Credential | O.D.
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Telephone | 972-288-2520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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