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General NPI Number Information
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NPI Number | 1710289376
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Entity Type | Organization
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Legal Business Name | MICHAEL T POYNOR OD PA
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Dates
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Enumeration Date | 12/02/2010
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Last Update Date | 09/01/2011
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Provider Practice Location Address
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Address Line | 110 N ADELAIDE ST
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City | TERRELL
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State | TX
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Zip | 75160-2709
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Country | US
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Telephone | 972-563-3253
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Fax |
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Provider Business Mailing Address
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Address Line | 807 W MARVIN AVE
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City | WAXAHACHIE
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State | TX
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Zip | 75165-3023
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Country | US
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Telephone | 972-937-6869
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL THOMAS POYNOR
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Credential | O.D.
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Telephone | 972-937-6869
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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 | 2294T
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License Number State | TX
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