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General NPI Number Information
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NPI Number | 1134171259
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Entity Type | Organization
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Legal Business Name | DALLAS EYE CARE ASSOCIATES PLLC
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 08/20/2020
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Provider Practice Location Address
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Address Line | 5494 GLEN LAKES DR
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City | DALLAS
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State | TX
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Zip | 75231-4308
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Country | US
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Telephone | 214-692-6220
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Fax | 214-696-1579
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Provider Business Mailing Address
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Address Line | 3900 E MEXICO AVE STE 102
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City | DENVER
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State | CO
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Zip | 80210-3941
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Country | US
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Telephone | 303-800-2078
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Fax | 303-800-2078
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Authorized Official
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Title or Position | CEO
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Name | CHRISTIAN ELLISON
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Credential |
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Telephone | 720-273-7449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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