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General NPI Number Information
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NPI Number | 1427189968
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Entity Type | Organization
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Legal Business Name | OPHTHALMOLOGY CONSULTANTS PA
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 3200 N MACARTHUR BLVD SUITE 200
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City | IRVING
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State | TX
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Zip | 75062-4453
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Country | US
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Telephone | 972-258-7979
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Fax | 972-570-5502
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Provider Business Mailing Address
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Address Line | 3200 N MACARTHUR BLVD SUITE 200
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City | IRVING
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State | TX
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Zip | 75062-4453
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Country | US
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Telephone | 972-258-7979
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Fax | 972-570-5502
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | EVERETT A MOODY
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Credential | M.D.
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Telephone | 972-258-7979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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