Organization
CRESCENT EYECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAREQ ISSAM NABHAN O.D. (OWNER/OPTOMETRIST)
(314) 479-9305
Entity
Organization
Contact information
Practice address
12110 SAINT CHARLES ROCK RD, BRIDGETON, MO 63044-2601
(314) 291-3700
(314) 291-3708
Mailing address
12110 SAINT CHARLES ROCK RD, BRIDGETON, MO 63044-2601
(314) 291-3700
(314) 291-3708
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2012020857
MO
Other
Enumeration date
02/09/2015
Last updated
02/09/2015
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