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Organization

SPECIALEYES OPTICAL, LLC

Active
Find providers by NPI
Organization

SPECIALEYES OPTICAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LORETTA TAYLOR (CREDENTIALING COORDINATOR)
(817) 529-9949
Entity
Organization

Contact information

Practice address
2212 EMERY ST, DENTON, TX 76201-1100
(940) 312-5900
(940) 312-5901
Mailing address
321 S HENDERSON ST, FORT WORTH, TX 76104-1016
(817) 529-9929
(817) 529-9927

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018440004
—
TX
05
—
145291402
—
TX
05
—
166926901
—
TX
05
—
207716601
—
TX
05
—
287401803
—
TX
05
—
294486001
—
TX
05
—
323588905
—
TX
05
—
375326101
—
TX
Enumeration date
10/16/2018
Last updated
06/11/2019
About Stedi
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