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General NPI Number Information
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NPI Number | 1427564293
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Entity Type | Organization
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Legal Business Name | DR. PAUL PUNTNEY, OPTOMETRIST
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Dates
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Enumeration Date | 12/15/2017
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Last Update Date | 12/15/2017
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Provider Practice Location Address
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Address Line | 6001 W WACO DR STE 106
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City | WACO
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State | TX
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Zip | 76710-6301
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Country | US
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Telephone | 254-399-9388
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Fax | 254-399-9123
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Provider Business Mailing Address
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Address Line | 6001 W WACO DR STE 106
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City | WACO
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State | TX
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Zip | 76710-6301
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Country | US
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Telephone | 254-399-9388
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Fax | 254-399-9123
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. SONIA K LANKFORD
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Credential |
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Telephone | 254-399-9388
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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 | TX2107T
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License Number State | TX
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