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General NPI Number Information
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NPI Number | 1891859005
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Entity Type | Organization
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Legal Business Name | HIGH PLAINS EYE HEALTH CENTER, INC.
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 03/02/2010
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Provider Practice Location Address
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Address Line | 3419 S COULTER ST SUITE 5
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City | AMARILLO
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State | TX
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Zip | 79109-3998
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Country | US
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Telephone | 806-359-5900
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Fax | 806-359-5353
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Provider Business Mailing Address
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Address Line | 3419 S COULTER ST SUITE 5
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City | AMARILLO
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State | TX
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Zip | 79109-3998
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Country | US
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Telephone | 806-359-5900
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Fax | 806-359-5353
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | DR. JOY M. BERRY
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Credential | O.D.
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Telephone | 806-359-5900
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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 | 5611T
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License Number State | TX
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