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General NPI Number Information
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NPI Number | 1457513343
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Entity Type | Organization
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Legal Business Name | DOUGLAS N. BLACK, O.D., P.A.
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 2000 N PLANO RD STE 111
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City | RICHARDSON
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State | TX
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Zip | 75082-4427
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Country | US
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Telephone | 972-234-3937
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Fax | 972-234-3982
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Provider Business Mailing Address
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Address Line | 2000 N PLANO RD STE 111
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City | RICHARDSON
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State | TX
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Zip | 75082-4427
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Country | US
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Telephone | 972-234-3937
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Fax | 972-234-3982
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Authorized Official
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Title or Position | INSURANCE COORDINATOR
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Name | ERIN HOLLAND
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Credential |
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Telephone | 972-234-3937
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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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