Larry Michael Chism, O.D.
Optometrist in Tyler, TX. Individual provider (NPI-1).
NPI number1376670216
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1376670216
- Entity type
- Individual (NPI-1)
- Name
- Larry Michael Chism
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 27, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 02774TG | TX | Yes |
Practice location
136 Shelley DrTyler, TX 75701-8723
Phone 903-561-8686 · Fax 906-581-1518
Mailing address
136 Shelley DrTyler, TX 75701-8723
Phone 903-561-8686 · Fax 906-581-1518
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