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NPI Code Detail

MEDICARE: 20-20 SIGHT OF LAKEWOOD PA

MEDICARE: 20-20 SIGHT OF LAKEWOOD PA
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
1152W00000XOptometrist5597TG

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669816849
Entity Type Code : Organization
Provider Name (Legal Business Name) : 20-20 SIGHT OF LAKEWOOD PA
Provider Business Mailing Address
First Line : 1905 ABRAMS RD
Second Line :
City : DALLAS
State : TX
Zip : 75214-3916
Country : US
Telephone Number : 214-821-2020
Fax Number : 214-821-2025
Provider Business Practice Location Address
First Line : 1905 ABRAMS RD
Second Line :
City : DALLAS
State : TX
Zip : 75214-3916
Country : US
Telephone Number : 214-821-2020
Fax Number : 972-264-7220
Authorized Official
Title or Position : DOCTOR
Name : DR. LARRY DON TARRANT
Credential : D.O.
Telephone Number : 214-773-3457
Provider Enumeration Date : 04/18/2013
Last Update Date : 08/01/2014

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Practice Location Address:
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75214-3916
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1568675130 — DOUGLAS ALAN LESTER DC
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1225241938 — SHANNON JILL FEATHERSTON DC
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1477766038 — JOHN GORDON KEPHART DC
Practice Location Address:
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DALLAS, TX
75214-3916
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1952514523 — KATHLEEN WESTFALL BROWN PT
Practice Location Address:
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1831459973 — RUBY RODRIGUEZ O.D.
Practice Location Address:
1905 ABRAMS RD
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75214-3916
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Directions to “20-20 SIGHT OF LAKEWOOD PA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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