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NPI Code Detail

MEDICARE: TEXARKANA EYE ASSOCIATES

MEDICARE: TEXARKANA EYE ASSOCIATES
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
1152W00000XOptometrist

General Provider Information

NPI Number : 1427413558
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEXARKANA EYE ASSOCIATES
Provider Business Mailing Address
First Line : 2510 N HERVEY ST
Second Line : SUITE A
City : HOPE
State : AR
Zip : 71801-8419
Country : US
Telephone Number : 870-722-2200
Fax Number :
Provider Business Practice Location Address
First Line : 2703 RICHMOND RD
Second Line :
City : TEXARKANA
State : TX
Zip : 75503-2328
Country : US
Telephone Number : 903-838-0783
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ELVIN W FENTON
Credential : OD
Telephone Number : 903-838-0731
Provider Enumeration Date : 12/16/2015
Last Update Date : 11/10/2016

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Directions to “TEXARKANA EYE ASSOCIATES ” Practice Location

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