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General NPI Number Information
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NPI Number | 1164718599
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Entity Type | Organization
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Legal Business Name | EYE CARE AVENUE, PC
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Dates
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Enumeration Date | 06/23/2011
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Last Update Date | 06/23/2011
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Provider Practice Location Address
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Address Line | 5000 ELDORADO PKWY SUITE 310
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City | FRISCO
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State | TX
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Zip | 75034-8695
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Country | US
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Telephone | 214-449-7980
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 ELDORADO PKWY SUITE 310
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City | FRISCO
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State | TX
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Zip | 75034-8695
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Country | US
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Telephone | 214-449-7980
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AMY DIANE RASMUSSEN
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Credential | O.D.
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Telephone | 972-837-8244
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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 | 6837TG
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License Number State | TX
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