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General NPI Number Information
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NPI Number | 1477681138
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Entity Type | Organization
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Legal Business Name | HENDERSON EYE ASSOCIATION, INC
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 06/16/2016
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Provider Practice Location Address
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Address Line | 1787 HIGHWAY 79 SOUTH
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City | HENDERSON
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State | TX
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Zip | 75654-4509
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Country | US
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Telephone | 903-657-1539
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Fax | 903-657-0259
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Provider Business Mailing Address
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Address Line | 1787 HIGHWAY 79 SOUTH
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City | HENDERSON
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State | TX
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Zip | 75654-4509
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Country | US
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Telephone | 903-657-1539
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Fax | 903-657-0259
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. BARBARA MCDONALD
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Credential | O.D.
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Telephone | 903-657-1539
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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 | 5144TG
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License Number State | TX
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