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General NPI Number Information
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NPI Number | 1396924494
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Entity Type | Organization
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Legal Business Name | MICHAEL BOLLISH, O.D. P.C.
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Dates
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Enumeration Date | 10/25/2007
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 6850 NORTH SHILOH ROAD STE T
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City | GARLAND
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State | TX
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Zip | 75044-2918
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Country | US
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Telephone | 972-414-0444
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Fax | 972-414-5663
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Provider Business Mailing Address
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Address Line | 6850 N SHILOH ROAD SUITE T
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City | GARLAND
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State | TX
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Zip | 75044-2918
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Country | US
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Telephone | 972-414-0444
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Fax | 972-414-5663
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL JAMES BOLLISH
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Credential | O.D.
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Telephone | 972-414-0444
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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 | 3918
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License Number State | TX
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