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General NPI Number Information
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NPI Number | 1306024823
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Entity Type | Organization
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Legal Business Name | THOMAS W GREENE, O.D.,P.C.
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 501 E LONDON ST
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City | BOWIE
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State | TX
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Zip | 76230-3020
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Country | US
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Telephone | 940-872-5417
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Fax | 940-872-6754
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Provider Business Mailing Address
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Address Line | PO BOX 31
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City | BOWIE
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State | TX
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Zip | 76230-0031
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Country | US
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Telephone | 940-872-5417
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Fax | 940-872-6754
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. THOMAS W GREENE
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Credential | O.D.
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Telephone | 940-872-5417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 2610T
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License Number State | TX
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