Elysian Eyecare PLLC
Clinic/Center in Mansfield, TX. Organization (NPI-2).
NPI number1013502004
StatusActive
Last updated in NPPESMar 2, 2021
Details
- NPI
- 1013502004
- Entity type
- Organization (NPI-2)
- Legal business name
- Elysian Eyecare PLLC
- Organization subpart
- No
- Enumeration date
- Mar 2, 2021
- Certification date
- Mar 2, 2021
- Last updated
- Mar 2, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Other names
- Unique Vision (Doing Business As)
Practice location
1971 Highway 287 N Ste 105Mansfield, TX 76063-8983
Phone 817-453-7591 · Fax 817-453-7715
Mailing address
1971 Highway 287 N Ste 105Mansfield, TX 76063-8983
Phone 817-453-7591
Authorized official
Phuong Pham
Optometrist
3472791020
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