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Organization
PACK OPTICAL
Active
Organization
PACK OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN M PACK O.D. (OWNNER)
(817) 831-6141
Entity
Organization
Contact information
Practice address
1217 OAK KNOLL DR, FORT WORTH, TX 76117-5505
(817) 831-6141
Mailing address
1217 OAK KNOLL DR, FORT WORTH, TX 76117-5505
(817) 831-6141
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
12/31/2007
Last updated
02/07/2008
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