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General NPI Number Information
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NPI Number | 1528290954
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Entity Type | Organization
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Legal Business Name | JP AL EYE ASSOCIATES PLLC
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Dates
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Enumeration Date | 08/18/2009
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Last Update Date | 01/27/2010
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Provider Practice Location Address
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Address Line | 1400 PRECINCT LINE RD
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City | HURST
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State | TX
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Zip | 76053-3828
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Country | US
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Telephone | 817-282-1975
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 PRECINCT LINE RD
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City | HURST
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State | TX
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Zip | 76053-3828
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Country | US
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Telephone | 214-490-8784
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | AARON LEE
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Credential | OD
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Telephone | 214-490-8784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 7408TG
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7408TG
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License Number State | TX
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