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General NPI Number Information
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NPI Number | 1720264468
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Entity Type | Organization
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Legal Business Name | PASSONS EYE CENTER, P.L.L.C.
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Dates
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Enumeration Date | 01/11/2008
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 909 RIDGEWAY LOOP RD
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City | MEMPHIS
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State | TN
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Zip | 38120-4016
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Country | US
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Telephone | 901-683-1112
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Fax | 901-683-1174
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Provider Business Mailing Address
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Address Line | 909 RIDGEWAY LOOP RD
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City | MEMPHIS
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State | TN
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Zip | 38120-4016
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Country | US
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Telephone | 901-683-1112
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Fax | 901-683-1174
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Authorized Official
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Title or Position | OWNER
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Name | DR. GARY A. PASSONS
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Credential | MD
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Telephone | 901-683-1112
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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 | TNOD641T
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD36450
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD43481
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD12831
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License Number State | TN
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