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Organization
OPTICAL BOUTIQUE AND EYECARE
Active
Organization
OPTICAL BOUTIQUE AND EYECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIELLE GLOSTER O.D. (OWNER)
(972) 223-2020
Entity
Organization
Contact information
Practice address
1233 E PLEASANT RUN RD STE A, DESOTO, TX 75115-4200
(972) 223-2020
(972) 228-1860
Mailing address
PO BOX 444, LANCASTER, TX 75146-0444
(972) 223-2020
(972) 228-1860
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
156FX1201X
Optometric Assistant Technician
—
—
156FX1202X
Optometric Technician
—
—
156FX1800X
Optician
—
—
Other
Enumeration date
06/17/2020
Last updated
11/09/2020
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