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General NPI Number Information
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NPI Number | 1114185089
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Entity Type | Organization
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Legal Business Name | LARRY TARRANT O.D.
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Dates
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Enumeration Date | 05/28/2008
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Last Update Date | 05/28/2008
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Provider Practice Location Address
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Address Line | 1900 W MOORE AVE SUITE 200
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City | TERRELL
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State | TX
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Zip | 75160-2346
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Country | US
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Telephone | 972-551-2000
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Fax | 972-551-2011
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Provider Business Mailing Address
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Address Line | 104 W US HIGHWAY 80 SUITE 100
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City | FORNEY
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State | TX
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Zip | 75126
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Country | US
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Telephone | 972-551-2000
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Fax | 972-551-2011
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Authorized Official
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Title or Position | OWNER
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Name | DR. LARRY D TARRANT
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Credential | O.D.
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Telephone | 972-551-2000
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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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