MEDICARE: ROSALYN LIEN OD

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	9660T	TX

General Provider Information

NPI Number	:	1851943401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSALYN LIEN OD

Provider Business Mailing Address
First Line	:	2328 OLD PECOS TRL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76131-1645
Country	:	US
Telephone Number	:	972-352-7333
Fax Number	:

Provider Business Practice Location Address
First Line	:	7728 MID CITIES BLVD
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-4621
Country	:	US
Telephone Number	:	817-218-3386
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2019
Last Update Date	:	02/18/2020

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Directions to “ ROSALYN LIEN OD” Practice Location

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