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NPI Code Detail

MEDICARE: DR. ALYSSA FORD O.D.

MEDICARE: DR. ALYSSA FORD O.D.
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
1152W00000XOptometrist8173TTX

General Provider Information

NPI Number : 1437598547
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALYSSA FORD O.D.
Provider Business Mailing Address
First Line : PO BOX 821112
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76182-1112
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1450 EASTCHASE PKWY
Second Line :
City : FORT WORTH
State : TX
Zip : 76120-4429
Country : US
Telephone Number : 817-460-6449
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2013
Last Update Date : 09/28/2016

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Directions to “ DR. ALYSSA FORD O.D.” Practice Location

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