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General NPI Number Information
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NPI Number | 1235148560
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Entity Type | Organization
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Legal Business Name | KENNETH I UZICK OD PC
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 8335 WESTCHESTER AVE # 120
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City | DALLAS
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State | TX
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Zip | 75225-5717
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Country | US
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Telephone | 214-361-1010
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Fax | 214-823-9503
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Provider Business Mailing Address
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Address Line | 8335 WESTCHESTER AVE #120
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City | DALLAS
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State | TX
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Zip | 75225-5717
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Country | US
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Telephone | 214-361-1010
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Fax | 214-823-9503
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENNETH I UZICK
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Credential | O.D. PC
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Telephone | 214-361-1010
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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 | 5037TG
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License Number State | TX
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