Advanced Visioncare Of Desoto PA
Optometrist in Desoto, TX. Organization (NPI-2).
NPI number1962702654
StatusActive
Last updated in NPPESOct 27, 2010
Details
- NPI
- 1962702654
- Entity type
- Organization (NPI-2)
- Legal business name
- Advanced Visioncare Of Desoto PA
- Organization subpart
- No
- Enumeration date
- Oct 27, 2010
- Last updated
- Oct 27, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 4711T | TX | Yes |
Practice location
600 N Hampton RdDesoto, TX 75115-4508
Phone 972-223-5354 · Fax 972-274-0607
Mailing address
600 N Hampton RdDesoto, TX 75115-4508
Phone 972-223-5354 · Fax 972-274-0607
Authorized official
James Kevin Smith
Manager
9722235354
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