=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942152061
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DRY EYE CENTER OF ARKANSAS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/11/2026
-----------------------------------------------------
Last Update Date | 02/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 500 S UNIVERSITY AVE STE 702
-----------------------------------------------------
City | LITTLE ROCK
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72205-5309
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-508-2660
-----------------------------------------------------
Fax | 501-916-4904
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 500 S UNIVERSITY AVE STE 702
-----------------------------------------------------
City | LITTLE ROCK
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72205-5309
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-508-2660
-----------------------------------------------------
Fax | 501-916-4904
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OPTOMETRIST/OWNER
-----------------------------------------------------
Name | DR. SHELBY RAE BROGDON
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 501-508-2660
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------