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General NPI Number Information
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NPI Number | 1871714683
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Entity Type | Organization
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Legal Business Name | DANN MARTIN O.D.,P.A.
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 08/25/2015
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Provider Practice Location Address
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Address Line | 5520 S COOPER ST SUITE 110
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City | ARLINGTON
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State | TX
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Zip | 76017-4404
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Country | US
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Telephone | 817-467-2020
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Fax | 817-375-8210
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Provider Business Mailing Address
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Address Line | 5520 S COOPER ST SUITE 110
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City | ARLINGTON
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State | TX
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Zip | 76017-4404
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Country | US
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Telephone | 817-467-2020
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Fax | 817-375-8210
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Authorized Official
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Title or Position | OWNER PROFESSIONAL ASSOCIATION
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Name | DR. DANN CRAIG MARTIN
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Credential | O.D., P.A.
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Telephone | 817-467-2020
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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 | 04835TG
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License Number State | TX
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