| Keller Premier Eye Care | |
|
900 S Main St Ste 351 Keller TX 76248-7024 | |
| (817) 527-9800 | |
| (817) 993-4033 |
| Full Name | Keller Premier Eye Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 900 S Main St Ste 351, Keller, Texas |
| Authorized Official Name and Position | Anwi Ngando Etame (O.D./ OPTOMETRIST) |
| Authorized Official Contact | 5038099624 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keller Premier Eye Care 2012 Cedar Ridge Dr Keller TX 76248-8355 Ph: (503) 809-9624 | Keller Premier Eye Care 900 S Main St Ste 351 Keller TX 76248-7024 Ph: (817) 527-9800 |
| NPI Number | 1881236008 |
|---|---|
| Provider Enumeration Date | 10/09/2019 |
| Last Update Date | 10/19/2019 |
| Medicare PECOS PAC ID | 1759713076 |
|---|---|
| Medicare Enrollment ID | O20191107000698 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881236008 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Anwi Etame |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831399591 PECOS PAC ID: 1658465513 Enrollment ID: I20181020000176 |
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