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General NPI Number Information
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NPI Number | 1841996592
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Entity Type | Organization
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Legal Business Name | EYEMAX FAMILY VISION PLLC
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Dates
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Enumeration Date | 02/03/2023
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 4880 ELDORADO PKWY STE 200
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City | FRISCO
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State | TX
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Zip | 75033-1229
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Country | US
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Telephone | 972-372-0333
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Fax | 972-638-8588
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Provider Business Mailing Address
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Address Line | 10414 CRESTOVER DR
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City | DALLAS
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State | TX
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Zip | 75229-5215
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Country | US
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Telephone | 972-850-8001
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MALIK MAMDANI
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Credential |
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Telephone | 972-850-8001
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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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