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General NPI Number Information
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NPI Number | 1124932108
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Entity Type | Organization
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Legal Business Name | EYEWORKS NORTH FORT WORTH LLC
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 7367 N BEACH ST STE 100
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City | FORT WORTH
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State | TX
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Zip | 76137-1803
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Country | US
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Telephone | 817-346-7077
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Fax | 817-346-6998
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Provider Business Mailing Address
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Address Line | 4631 S HULEN ST
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City | FORT WORTH
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State | TX
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Zip | 76132-1401
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Country | US
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Telephone | 817-346-7077
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Fax | 817-346-6998
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | TAYA LOCKLAR
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Credential |
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Telephone | 817-346-7077
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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 | NULL
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