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General NPI Number Information
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NPI Number | 1902982135
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Entity Type | Organization
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Legal Business Name | ADVANCED EYECARE
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 03/12/2009
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Provider Practice Location Address
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Address Line | 1314 DOCTORS DR
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City | TYLER
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State | TX
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Zip | 75701-2262
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Country | US
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Telephone | 903-595-6592
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Fax | 903-593-5972
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Provider Business Mailing Address
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Address Line | 1314 DOCTORS DR
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City | TYLER
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State | TX
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Zip | 75701-2262
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Country | US
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Telephone | 903-595-6592
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Fax | 903-593-5972
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSHUA S HOOPER
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Credential | O.D.
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Telephone | 903-595-6592
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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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