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General NPI Number Information
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NPI Number | 1285254086
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Entity Type | Organization
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Legal Business Name | OPTIMAL FAMILY EYE CARE, PLLC
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Dates
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Enumeration Date | 04/21/2020
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Last Update Date | 04/24/2020
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Provider Practice Location Address
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Address Line | 1629 N TOWN EAST BLVD
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City | MESQUITE
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State | TX
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Zip | 75150-4105
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Country | US
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Telephone | 972-686-6000
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Fax | 972-686-6111
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Provider Business Mailing Address
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Address Line | 373 MIDSTREAM DR
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City | SUNNYVALE
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State | TX
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Zip | 75182-3244
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Country | US
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Telephone | 314-322-4155
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Fax |
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. JAISY J KASTNER
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Credential | OD
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Telephone | 314-322-4155
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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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