Organization
VISTA OPHTHALMOLOGY ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAGHAV R GUPTA MD (PRESIDENT/OWNER)
(214) 618-3937
Entity
Organization
Contact information
Practice address
10210 N CENTRAL EXPY, 125, DALLAS, TX 75231-3425
(214) 369-5343
(214) 369-4090
Mailing address
5575 WARREN PKWY SUITE 210, FRISCO, TX 75034-4066
(214) 618-3937
(214) 618-3984
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158172002
—
TX
Enumeration date
09/27/2006
Last updated
01/18/2012
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