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General NPI Number Information
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NPI Number | 1508516618
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Entity Type | Organization
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Legal Business Name | ENHANCED EYE CARE TEXAS
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 06/05/2022
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Provider Practice Location Address
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Address Line | 5325 MCPHERSON BLVD STE 125
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City | FORT WORTH
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State | TX
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Zip | 76123-6028
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Country | US
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Telephone | 817-935-8280
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Fax | 817-935-8281
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Provider Business Mailing Address
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Address Line | 1603 HACKNEY DR
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City | MANSFIELD
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State | TX
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Zip | 76063-4262
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Country | US
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Telephone | 214-729-7787
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HIEP DUONG
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Credential | OD
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Telephone | 214-729-7787
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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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