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General NPI Number Information
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NPI Number | 1407942741
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Entity Type | Individual
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Provider Name | BEN B DONALD II OD
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Gender | Male
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 403 N ADAMS ST
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City | CARTHAGE
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State | TX
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Zip | 75633-1311
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Country | US
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Telephone | 903-694-2300
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Fax | 903-694-2333
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Provider Business Mailing Address
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Address Line | 403 N ADAMS ST
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City | CARTHAGE
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State | TX
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Zip | 75633
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Country | US
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Telephone | 903-694-2300
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Fax | 903-694-2333
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4453TG
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License Number State | TX
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