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General NPI Number Information
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NPI Number | 1336579770
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Entity Type | Organization
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Legal Business Name | EXCELLENT EYE CARE P.A.
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Dates
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Enumeration Date | 11/21/2013
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Last Update Date | 11/21/2013
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Provider Practice Location Address
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Address Line | 2665 MARKET CENTER DR STE 100
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City | ROCKWALL
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State | TX
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Zip | 75032-6563
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Country | US
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Telephone | 972-772-9659
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Fax | 972-772-3120
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Provider Business Mailing Address
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Address Line | 2665 MARKET CENTER DR STE 100
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City | ROCKWALL
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State | TX
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Zip | 75032-6563
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Country | US
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Telephone | 972-772-9659
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Fax | 972-772-3120
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. MONICA QUYNH NGUYEN
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Credential | O.D.
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Telephone | 972-772-9659
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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 | 6813T
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License Number State | TX
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