Individual
DR. JOE EDWARD BROADWAY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2355 N STATE HIGHWAY 360 APT 625, GRAND PRAIRIE, TX 75050-8716
(972) 822-3148
Mailing address
2355 N STATE HIGHWAY 360 APT 625, GRAND PRAIRIE, TX 75050-8716
(972) 822-3148
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11188
TX
Other
Enumeration date
05/23/2024
Last updated
05/23/2024
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