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General NPI Number Information
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NPI Number | 1932951902
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Entity Type | Organization
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Legal Business Name | EYE CARE OF TEXOMA, LLC
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Dates
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Enumeration Date | 04/03/2024
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Last Update Date | 04/03/2024
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Provider Practice Location Address
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Address Line | 417 W MAIN ST
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City | DENISON
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State | TX
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Zip | 75020-3126
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Country | US
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Telephone | 903-465-3815
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Fax |
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Provider Business Mailing Address
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Address Line | 1235 LAKE RIDGE CT
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City | POTTSBORO
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State | TX
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Zip | 75076-3225
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERIC NEWBERRY
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Credential | OD
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Telephone | 214-616-3221
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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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