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General NPI Number Information
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NPI Number | 1467502443
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Entity Type | Organization
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Legal Business Name | EYE HEALTH ASSOCIATES, P.A.
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | 338 S MAIN ST
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City | GRAPEVINE
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State | TX
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Zip | 76051-5319
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Country | US
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Telephone | 817-481-2411
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Fax | 817-481-0203
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Provider Business Mailing Address
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Address Line | 338 S MAIN ST
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City | GRAPEVINE
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State | TX
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Zip | 76051-5319
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Country | US
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Telephone | 817-481-2411
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Fax | 817-481-0203
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TOM LOUIS CHANDLER
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Credential | O.D.
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Telephone | 817-481-3231
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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 | 1902TG
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License Number State | TX
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