MEDICARE: DALLAS OPHTHALMOLOGY CENTER INC

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	367500000X	Certified Registered Nurse Anesthetist

General Provider Information

NPI Number	:	1447239538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALLAS OPHTHALMOLOGY CENTER INC

Provider Business Mailing Address
First Line	:	4633 NORTH CENTRAL EXPRESSWAY
Second Line	:	STE 310
City	:	DALLAS
State	:	TX
Zip	:	75205-4022
Country	:	US
Telephone Number	:	214-520-7600
Fax Number	:	214-520-6522

Provider Business Practice Location Address
First Line	:	4633 NORTH CENTRAL EXPRESSWAY
Second Line	:	STE 310
City	:	DALLAS
State	:	TX
Zip	:	75205-4022
Country	:	US
Telephone Number	:	214-520-7600
Fax Number	:	214-520-6522

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SUSAN POINTS
Credential	:	RN
Telephone Number	:	214-520-7600

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	08/22/2020

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