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General NPI Number Information
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NPI Number | 1376931394
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Entity Type | Organization
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Legal Business Name | KL VISION ASSOCIATES, PLLC
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Dates
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Enumeration Date | 12/29/2014
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Last Update Date | 12/29/2014
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Provider Practice Location Address
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Address Line | 8000 DENTON HWY
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City | WATAUGA
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State | TX
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Zip | 76148-2464
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Country | US
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Telephone | 817-864-8701
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Fax | 817-864-8701
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Provider Business Mailing Address
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Address Line | 8000 DENTON HWY
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City | WATAUGA
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State | TX
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Zip | 76148-2464
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Country | US
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Telephone | 817-864-8701
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Fax | 817-864-8701
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DUNG KHUAT
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Credential | OD
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Telephone | 817-864-8701
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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 | 7603TG
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License Number State | TX
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