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General NPI Number Information
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NPI Number | 1720804933
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Entity Type | Organization
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Legal Business Name | ROLLING HILLS EYE CARE PLLC
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 700 4TH ST
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City | BLANCO
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State | TX
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Zip | 78606-5569
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Country | US
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Telephone | 253-549-3074
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Fax |
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Provider Business Mailing Address
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Address Line | 700 4TH ST
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City | BLANCO
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State | TX
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Zip | 78606-5569
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Country | US
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Telephone | 830-554-9332
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. CHARLES R DALE JR.
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Credential | OD
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Telephone | 253-549-3074
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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 |
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License Number State |
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