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General NPI Number Information
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NPI Number | 1831227438
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Entity Type | Organization
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Legal Business Name | EYELAND VISION
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 10710 GATEWAY BLVD N STE. B-10
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City | EL PASO
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State | TX
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Zip | 79924-1739
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Country | US
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Telephone | 915-821-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 10710 GATEWAY BLVD N STE. B-10
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City | EL PASO
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State | TX
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Zip | 79924-1739
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Country | US
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Telephone | 915-821-6800
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Fax |
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Authorized Official
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Title or Position | V.P.
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Name | DR. KERRY THOMAS HOLT
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Credential | O.D.
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Telephone | 915-821-6800
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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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