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General NPI Number Information
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NPI Number | 1679745392
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Entity Type | Organization
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Legal Business Name | MARKOSE EYE ASSOCIATES INC.
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Dates
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Enumeration Date | 04/02/2008
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Last Update Date | 04/25/2012
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Provider Practice Location Address
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Address Line | 190 E ROUND GROVE RD
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City | LEWISVILLE
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State | TX
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Zip | 75067-8301
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Country | US
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Telephone | 469-549-0987
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Fax | 469-549-0989
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Provider Business Mailing Address
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Address Line | 190 E ROUND GROVE RD
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City | LEWISVILLE
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State | TX
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Zip | 75067-8301
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Country | US
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Telephone | 469-549-0987
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Fax | 469-549-0989
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Authorized Official
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Title or Position | OWNER
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Name | LYNN MARKOSE
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Credential | O.D.
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Telephone | 469-549-0987
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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 | 6704T
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License Number State | TX
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