MEDICARE: REFRACTIVE PRECISION LASER CENTER LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1003874116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REFRACTIVE PRECISION LASER CENTER LP

Provider Business Mailing Address
First Line	:	7150 GREENVILLE AVE
Second Line	:	SUITE 250 GREENVILLE MEDICAL TOWER
City	:	DALLAS
State	:	TX
Zip	:	75231-7900
Country	:	US
Telephone Number	:	241-890-9883
Fax Number	:

Provider Business Practice Location Address
First Line	:	7150 GREENVILLE AVE
Second Line	:	SUITE 250 GREENVILLE MEDICAL TOWER
City	:	DALLAS
State	:	TX
Zip	:	75231-7900
Country	:	US
Telephone Number	:	241-890-9883
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KIMBERLY WOOD
Credential	:
Telephone Number	:	828-236-3027

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	08/31/2007

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