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General NPI Number Information
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NPI Number | 1275769416
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Entity Type | Organization
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Legal Business Name | ANDERSON EYE CARE INC
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Dates
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Enumeration Date | 06/02/2009
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Last Update Date | 06/02/2009
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Provider Practice Location Address
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Address Line | 801 HEBRON PKWY APT 4201
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City | LEWISVILLE
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State | TX
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Zip | 75057-5030
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Country | US
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Telephone | 219-613-0033
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Fax |
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Provider Business Mailing Address
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Address Line | 5549 LBJ FWY
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City | DALLAS
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State | TX
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Zip | 75240-6208
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Country | US
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Telephone | 214-265-7781
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Fax | 972-239-2513
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Authorized Official
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Title or Position | OWNING OPTOMETRIST
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Name | DR. VALERIE ANDERSON
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Credential | O.D.
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Telephone | 214-265-7781
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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 |
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License Number State |
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