| |
3600 Fm 407 E Ste 190, Lantana, TX 76226-9743 | |
(940) 251-0919 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 3600 Fm 407 E Ste 190, Lantana, Texas |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1639701196 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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8614 Westwood Center Dr Fl 9, Vienna, VA 22182-2442 Ph: (703) 847-8899 | 3600 Fm 407 E Ste 190, Lantana, TX 76226-9743 Ph: (940) 251-0919 |