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General NPI Number Information
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NPI Number | 1659081917
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Entity Type | Organization
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Legal Business Name | CLEAR EYE & OPTICAL FLOWER MOUND PLLC
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Dates
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Enumeration Date | 11/28/2022
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Last Update Date | 11/28/2022
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Provider Practice Location Address
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Address Line | 1124 W MAIN ST
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City | LEWISVILLE
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State | TX
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Zip | 75067-3469
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Country | US
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Telephone | 254-964-4143
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1740
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City | GRANBURY
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State | TX
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Zip | 76048-8740
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Country | US
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Telephone | 254-964-4143
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID ALLEN MOORE
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Credential | OD
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Telephone | 254-964-4143
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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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