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General NPI Number Information
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NPI Number | 1932622305
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Entity Type | Organization
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Legal Business Name | JZJ VISION SCIENCE PLLC
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Dates
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Enumeration Date | 07/18/2017
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Last Update Date | 01/29/2019
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Provider Practice Location Address
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Address Line | 951 W BELT LINE RD
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City | DESOTO
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State | TX
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Zip | 75115-3741
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Country | US
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Telephone | 469-530-5575
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Fax |
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Provider Business Mailing Address
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Address Line | 4041 ALPHA RD
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City | FARMERS BRANCH
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State | TX
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Zip | 75244-4202
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Country | US
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Telephone | 469-835-5748
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | SHYH JYE WANG
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Credential | O.D.
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Telephone | 469-835-5748
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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 | 6768
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License Number State | TX
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