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General NPI Number Information
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NPI Number | 1285989228
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Entity Type | Organization
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Legal Business Name | TEXAS EYE SURGEONS PA
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Dates
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Enumeration Date | 07/16/2012
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 825 LOTUS DR
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City | RICHARDSON
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State | TX
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Zip | 75081-5197
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Country | US
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Telephone | 469-999-8850
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Fax | 866-482-0873
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Provider Business Mailing Address
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Address Line | 825 LOTUS DR
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City | RICHARDSON
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State | TX
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Zip | 75081-5197
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Country | US
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Telephone | 469-999-8850
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Fax | 866-482-0873
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Authorized Official
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Title or Position | PRESIDENT
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Name | ABDULFATAH M ALI
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Credential | MD
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Telephone | 469-999-8850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | PO532
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License Number State | TX
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