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General NPI Number Information
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NPI Number | 1447810080
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Entity Type | Individual
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Provider Name | JULIE ERVIN OD
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Gender | Female
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Dates
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Enumeration Date | 06/17/2019
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 2902 RACE ST
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City | FORT WORTH
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State | TX
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Zip | 76111-4104
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Country | US
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Telephone | 682-747-6319
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Fax | 817-238-3511
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Provider Business Mailing Address
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Address Line | 2902 RACE ST
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City | FORT WORTH
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State | TX
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Zip | 76111-4104
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Country | US
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Telephone | 214-763-3409
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Fax | 817-238-3511
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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 | 9698TG
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License Number State | TX
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