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General NPI Number Information
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NPI Number | 1689891772
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Entity Type | Organization
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Legal Business Name | WEST TEXAS VISION CENTER
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 05/05/2010
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Provider Practice Location Address
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Address Line | 301 NW AVENUE B
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City | ANDREWS
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State | TX
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Zip | 79714-5708
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Country | US
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Telephone | 432-523-2660
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Fax | 432-523-6312
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Provider Business Mailing Address
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Address Line | 301 NW AVENUE B
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City | ANDREWS
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State | TX
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Zip | 79714-5708
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Country | US
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Telephone | 432-523-2660
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Fax | 432-523-6312
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Authorized Official
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Title or Position | OWNER
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Name | DR. DENNIS K NEELY
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Credential | O.D.
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Telephone | 432-523-2660
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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 | 3371TG
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License Number State | TX
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