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General NPI Number Information
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NPI Number | 1285597807
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Entity Type | Organization
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Legal Business Name | KY DOCTORS OF OPTOMETRY, PLLC
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 1001 CHERRY BLOSSOM WAY
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City | GEORGETOWN
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State | KY
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Zip | 40324-9564
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Country | US
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Telephone | 726-444-4078
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Fax |
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Provider Business Mailing Address
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Address Line | 19100 RIDGEWOOD PKWY
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City | SAN ANTONIO
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State | TX
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Zip | 78259-1834
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Country | US
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Telephone | 726-444-4078
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Fax | 210-524-6587
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Authorized Official
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Title or Position | OWNER
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Name | GRANT RUBESH
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Credential |
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Telephone | 502-449-2080
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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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