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General NPI Number Information
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NPI Number | 1548482144
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Entity Type | Organization
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Legal Business Name | J. FERRELL HARTIN, OD, PC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/23/2010
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Provider Practice Location Address
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Address Line | 5300 SAN DARIO AVE MALL DEL NORTE, SEARS
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City | LAREDO
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State | TX
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Zip | 78041-3000
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Country | US
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Telephone | 210-865-0202
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Fax |
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Provider Business Mailing Address
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Address Line | 14802 TURKEY TRL
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City | SAN ANTONIO
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State | TX
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Zip | 78232-4511
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Country | US
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Telephone | 210-865-0202
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Fax |
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Authorized Official
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Title or Position | EYE CARE DIRECTOR AND PROVIDER
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Name | DR. JAMES FERRELL HARTIN
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Credential | O.D.
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Telephone | 210-499-5104
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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 | 1764T
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License Number State | TX
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