Organization
ELLIS COUNTY OPTICAL, INC.
Active
Parent organization
DAVID W. REAGAN
Other names
Classic Optical
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAVID W. REAGAN
Authorized official
DR. PAIGE A POLLARD O.D. (DR.)
(682) 518-9393
Entity
Organization
Contact information
Practice address
101 YMCA DR, WAXAHACHIE, TX 75165-5124
(972) 937-9757
(972) 938-2966
Mailing address
101 YMCA DR, WAXAHACHIE, TX 75165-5124
(972) 937-9757
(972) 938-2966
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
H-1191
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00936T
MEDICARE PTAN
—
Enumeration date
11/01/2007
Last updated
11/01/2007
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