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General NPI Number Information
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NPI Number | 1316282841
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Entity Type | Organization
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Legal Business Name | ALP VISION CARE SERVICES, PLLC
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Dates
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Enumeration Date | 12/10/2012
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Last Update Date | 12/20/2012
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Provider Practice Location Address
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Address Line | 150 E HIGHWAY 67 SUITE 120
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City | DUNCANVILLE
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State | TX
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Zip | 75137-4476
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Country | US
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Telephone | 832-651-9016
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 WHITE FALLS DR
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City | DESOTO
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State | TX
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Zip | 75115-7850
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Country | US
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Telephone | 832-651-9016
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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 | ANTHONY L PETERSON
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Credential | OD
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Telephone | 832-651-9016
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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 | 7032TG
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License Number State | TX
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