# ALLIANCE RETINA OF TEXAS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Alliance Retina
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346787157
- **Authorized official:** DR. KIM-BINH THI MAI MD (CEO)
- **Authorized official phone:** (817) 617-7678

## Contact information

- **Practice address:** 3824 N TARRANT PKWY STE 310, FORT WORTH, TX 76244-5431
- **Practice address phone:** (817) 617-7678
- **Practice address fax:** (817) 617-7681
- **Mailing address:** 3824 N TARRANT PKWY STE 310, FORT WORTH, TX 76244-5431
- **Mailing address phone:** (817) 617-7678
- **Mailing address fax:** (817) 617-7681

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | Q4189 | TX | Yes |

## Other

- **Enumeration date:** 01/31/2017
- **Last updated:** 07/27/2020