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General NPI Number Information
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NPI Number | 1861618092
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Entity Type | Organization
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Legal Business Name | COLLIN CREEK EYE CLINIC P.A
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 11/05/2012
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Provider Practice Location Address
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Address Line | 2821 W PARKER RD SUITE1
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City | PLANO
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State | TX
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Zip | 75023-7950
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Country | US
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Telephone | 972-596-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 2821 W PARKER RD SUITE1
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City | PLANO
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State | TX
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Zip | 75023-7950
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Country | US
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Telephone | 972-596-3800
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAMIR PATTNI
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Credential | O.D
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Telephone | 972-596-3800
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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 | 4757TG
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License Number State | TX
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