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General NPI Number Information
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NPI Number | 1154503423
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Entity Type | Organization
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Legal Business Name | SHERRI RAST OPTOMETRY, INC.
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Dates
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Enumeration Date | 11/28/2007
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 6646 S STAPLES ST SUITE 108
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City | CORPUS CHRISTI
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State | TX
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Zip | 78413-5425
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Country | US
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Telephone | 361-854-1460
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Fax | 361-993-0900
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Provider Business Mailing Address
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Address Line | 7409 LAKE MICALA DR
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City | CORPUS CHRISTI
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State | TX
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Zip | 78413-5823
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Country | US
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Telephone | 361-854-1460
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Fax | 361-993-0900
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Authorized Official
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Title or Position | PRESIDENT OF CORPORATION
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Name | DR. SHERRI CHRISTINE RAST
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Credential | O.D.
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Telephone | 361-854-1460
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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 | 5396TG
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License Number State | TX
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