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General NPI Number Information
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NPI Number | 1255493466
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Entity Type | Individual
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Provider Name | JEFFREY K HOLLINGSWORTH O.D.
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Gender | Male
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 06/07/2012
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Provider Practice Location Address
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Address Line | 2041 N REDBUD BLVD STE 1
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City | MCKINNEY
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State | TX
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Zip | 75069-8214
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Country | US
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Telephone | 972-562-8292
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Fax | 972-547-3932
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Provider Business Mailing Address
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Address Line | 2941 MOSS CREEK CT
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City | MCKINNEY
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State | TX
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Zip | 75070-4748
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Country | US
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Telephone | 972-562-5822
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 5407TG
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License Number State | TX
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