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General NPI Number Information
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NPI Number | 1598740367
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Entity Type | Individual
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Provider Name | KELBY ATKINS TRUSTY O.D.
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Gender | Male
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 3111 UNICORN LAKE BLVD STE 100
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City | DENTON
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State | TX
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Zip | 76210-0117
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Country | US
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Telephone | 940-891-3937
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Fax | 940-591-8368
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Provider Business Mailing Address
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Address Line | 3111 UNICORN LAKE BLVD STE 100
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City | DENTON
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State | TX
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Zip | 76210-0118
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Country | US
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Telephone | 940-891-3937
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Fax | 940-591-8368
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3995TG
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 152WS0006X
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Taxonomy Name | Sports Vision Optometrist
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License Number | 3995TG
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3995TG
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License Number State | TX
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