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General NPI Number Information
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NPI Number | 1407929425
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Entity Type | Organization
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Legal Business Name | TILLEY EYE CARE CENTERS LLC
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 06/30/2018
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Provider Practice Location Address
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Address Line | 708 HILL COUNTRY DR SUITE 100
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City | KERRVILLE
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State | TX
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Zip | 78028
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Country | US
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Telephone | 830-257-5656
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Fax | 830-257-5856
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Provider Business Mailing Address
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Address Line | 708 HILL COUNTRY DR SUITE 100
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City | KERRVILLE
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State | TX
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Zip | 78028-6071
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Country | US
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Telephone | 830-257-5656
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Fax | 830-257-5856
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Authorized Official
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Title or Position | OWNER
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Name | TOBIN B TILLEY
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Credential | OD
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Telephone | 830-257-5656
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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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