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General NPI Number Information
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NPI Number | 1477710879
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Entity Type | Organization
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Legal Business Name | PALMER EYECARE, INC
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Dates
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Enumeration Date | 05/22/2008
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Last Update Date | 03/07/2014
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Provider Practice Location Address
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Address Line | 900 N AUSTIN AVE STE #605
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City | GEORGETOWN
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State | TX
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Zip | 78626-4345
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Country | US
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Telephone | 512-869-6586
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Fax | 512-869-6688
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Provider Business Mailing Address
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Address Line | 900 N AUSTIN AVE STE #605
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City | GEORGETOWN
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State | TX
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Zip | 78626-4345
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Country | US
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Telephone | 512-869-6586
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Fax | 512-869-6688
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. LORI DANELLE PALMER
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Credential | O.D.
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Telephone | 512-869-6586
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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 | 7069TG
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License Number State | TX
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