Organization
HENDERSON OPTICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN BRUHL M.D. (OPHTHALMOLOGIST)
(817) 336-3653
Entity
Organization
Contact information
Practice address
1201 SUMMIT AVE, FORT WORTH, TX 76102-4413
(817) 336-3653
(817) 332-4233
Mailing address
1201 SUMMIT AVE, FORT WORTH, TX 76102-4413
(817) 336-3653
(817) 332-4233
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019770901
—
TX
Enumeration date
11/01/2006
Last updated
03/04/2020
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