Individual
CAROLYN LEE HELBERT GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1213 HALL JOHNSON RD, SUITE # 300, COLLEYVILLE, TX 76034-5847
(817) 428-0400
(817) 428-0457
Mailing address
1213 HALL JOHNSON RD, STE 300, COLLEYVILLE, TX 76034-5847
(817) 428-0400
(817) 428-0457
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
03802TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03802TG
OPTOMETRY BOARD LICENSE #
TX
01
—
1336326966
GROUP NPI NUMBER
TX
01
—
MH0879063
DHE
TX
01
—
W0122304
DPS
TX
Enumeration date
08/05/2006
Last updated
10/02/2019
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