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General NPI Number Information
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NPI Number | 1417461815
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Entity Type | Organization
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Legal Business Name | LOOK VISION CARE LLC
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Dates
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Enumeration Date | 11/21/2017
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Last Update Date | 04/16/2018
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Provider Practice Location Address
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Address Line | 16066 STATE HIGHWAY 121 SUITE 700
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City | FRISCO
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State | TX
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Zip | 75035
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Country | US
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Telephone | 972-332-8276
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Fax | 833-790-4738
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Provider Business Mailing Address
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Address Line | 16066 STATE HWY 121 SUTIE 700
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City | FRISCO
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State | TX
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Zip | 75035
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Country | US
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Telephone | 972-332-8276
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Fax | 833-790-4738
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. DIEU THAI
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Credential | O.D.
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Telephone | 972-332-8276
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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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