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General NPI Number Information
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NPI Number | 1841249703
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Entity Type | Individual
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Provider Name | SYLVESTER WILLIAM HORA O.D.
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Gender | Male
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 01/04/2021
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Provider Practice Location Address
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Address Line | 155 N MAIN ST STE 101B
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City | COLLIERVILLE
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State | TN
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Zip | 38017-2650
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Country | US
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Telephone | 901-853-1420
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Fax | 901-853-1421
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Provider Business Mailing Address
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Address Line | 2295 HIGHWAY 196 S
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City | PIPERTON
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State | TN
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Zip | 38017-5733
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Country | US
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Telephone | 901-486-5211
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Fax |
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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 | ODT000810
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License Number State | TN
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