Organization
DUMAS VISION SOURCE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TORY WAYNE MOORE O.D. (OWNER)
(806) 935-2020
Entity
Organization
Contact information
Practice address
1301 E 1ST ST, DUMAS, TX 79029-3567
(806) 935-2020
(806) 934-9908
Mailing address
1301 E 1ST ST, DUMAS, TX 79029-3567
(806) 935-2020
(806) 934-9908
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4305TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19278301
—
TX
05
—
209723001
—
TX
05
—
209723002
—
TX
Enumeration date
02/05/2009
Last updated
11/08/2018
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