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General NPI Number Information
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NPI Number | 1336807940
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Entity Type | Organization
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Legal Business Name | EYES ON DALLAS PLLC
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Dates
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Enumeration Date | 12/01/2021
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 12835 PRESTON RD STE 218
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City | DALLAS
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State | TX
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Zip | 75230-1277
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Country | US
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Telephone | 214-890-9864
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Fax |
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Provider Business Mailing Address
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Address Line | 17752 AGAVE LN
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City | DALLAS
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State | TX
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Zip | 75252-8041
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Country | US
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Telephone | 972-768-3338
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. MAI NGUYEN
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Credential | OD
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Telephone | 214-890-9864
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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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