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NPI Code Detail

MEDICARE: DR. ERIC KEITH NEWBERRY O.D.

MEDICARE: DR. ERIC KEITH NEWBERRY 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
1152W00000XOptometrist5516TGTX

General Provider Information

NPI Number : 1518924307
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERIC KEITH NEWBERRY O.D.
Provider Business Mailing Address
First Line : 1716 W VIRGINIA ST
Second Line :
City : MCKINNEY
State : TX
Zip : 75069-7864
Country : US
Telephone Number : 972-562-0101
Fax Number : 972-562-0406
Provider Business Practice Location Address
First Line : 1716 W VIRGINIA ST
Second Line :
City : MCKINNEY
State : TX
Zip : 75069-7864
Country : US
Telephone Number : 972-562-0101
Fax Number : 972-562-0406
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2006
Last Update Date : 05/19/2015

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