MEDICARE: OPTIMUS EYE CARE, PLLC

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	152W00000X	Optometrist	7603TG	TX

General Provider Information

NPI Number	:	1477961431
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMUS EYE CARE, PLLC

Provider Business Mailing Address
First Line	:	6021 WALKER BLVD STE 111
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-0904
Country	:	US
Telephone Number	:	682-235-8285
Fax Number	:	682-235-8285

Provider Business Practice Location Address
First Line	:	6021 WALKER BLVD STE 111
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-0904
Country	:	US
Telephone Number	:	682-235-8285
Fax Number	:	682-235-8285

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DUNG KHUAT
Credential	:	OD
Telephone Number	:	682-235-8285

Provider Enumeration Date	:	07/22/2014
Last Update Date	:	10/17/2020

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