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NPI Code Detail

MEDICARE: MONA MERCHANT OD

MEDICARE: MONA MERCHANT OD
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
1152W00000XOptometrist07246TGTX

General Provider Information

NPI Number : 1366778342
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONA MERCHANT OD
Provider Business Mailing Address
First Line : 4645 PLANO PKWY APT 2202
Second Line :
City : CARROLLTON
State : TX
Zip : 75010-4946
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 18121 MARSH LN
Second Line :
City : DALLAS
State : TX
Zip : 75287-5742
Country : US
Telephone Number : 972-862-2262
Fax Number : 972-862-2273
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2009
Last Update Date : 02/04/2010

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Directions to “ MONA MERCHANT OD” Practice Location

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