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General NPI Number Information
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NPI Number | 1720517477
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Entity Type | Individual
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Provider Name | LAYNE MARI FORD OD
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Gender | Female
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Dates
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Enumeration Date | 06/07/2017
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Last Update Date | 06/08/2020
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Provider Practice Location Address
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Address Line | 714 HILL COUNTRY DR
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City | KERRVILLE
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State | TX
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Zip | 78028-6066
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Country | US
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Telephone | 308-315-3673
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Fax | 830-315-3939
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Provider Business Mailing Address
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Address Line | 714 HILL COUNTRY DR
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City | KERRVILLE
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State | TX
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Zip | 78028-6066
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Country | US
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Telephone | 830-315-3673
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Fax | 830-315-3939
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 9192
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License Number State | TX
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