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General NPI Number Information
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NPI Number | 1912629205
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Entity Type | Organization
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Legal Business Name | LEGACY EYE PIECES PC
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Dates
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Enumeration Date | 09/14/2022
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Last Update Date | 09/14/2022
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Provider Practice Location Address
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Address Line | 7200 BISHOP RD STE D14
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City | PLANO
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State | TX
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Zip | 75024-3640
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Country | US
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Telephone | 972-661-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 7200 BISHOP RD STE D14
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City | PLANO
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State | TX
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Zip | 75024-3640
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Country | US
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Telephone | 972-661-2020
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | CHRISTOPHER DARILEK
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Credential | OD
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Telephone | 214-219-4402
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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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