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General NPI Number Information
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NPI Number | 1528472099
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Entity Type | Organization
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Legal Business Name | DR. SOPHEAR SENG, LLC
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Dates
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Enumeration Date | 06/12/2014
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Last Update Date | 06/12/2014
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Provider Practice Location Address
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Address Line | 2700 S SHACKLEFORD RD
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City | LITTLE ROCK
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State | AR
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Zip | 72205-6918
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Country | US
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Telephone | 501-225-5580
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Fax | 501-225-5582
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Provider Business Mailing Address
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Address Line | 2700 S SHACKLEFORD RD
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City | LITTLE ROCK
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State | AR
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Zip | 72205-6918
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Country | US
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Telephone | 501-225-5580
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Fax | 501-225-5582
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Authorized Official
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Title or Position | OWNER
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Name | SOPHEAR SENG
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Credential |
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Telephone | 501-225-5580
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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 | 2699
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License Number State | AR
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