Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 8821 Ladue Rd, Ladue, Missouri |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376886556 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | T02892 (Missouri) | Primary |
Mailing Address | Practice Location Address |
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Po Box 207158, Dallas, TX 75320-7158 Ph: (636) 200-4393 | 8821 Ladue Rd, Ladue, MO 63124 Ph: (636) 200-4393 |