Organization
TEXOMA RETINA CENTER PA
Active
Other names
TEXOMA RETINA AND GLAUCOMA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAY KHETPAL MD (DIRECTOR)
(903) 337-0055
Entity
Organization
Contact information
Practice address
1303 N SAM RAYBURN FWY # 100, SHERMAN, TX 75090-5030
(903) 337-0055
(903) 337-0060
Mailing address
1303 N SAM RAYBURN FWY # 100, SHERMAN, TX 75090-5030
(903) 337-0055
(903) 337-0060
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
—
—
207WX0107X
Retina Specialist (Ophthalmology) Physician
—
—
207WX0108X
Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
—
—
261QS0132X
Ophthalmologic Surgery Clinic/Center
P2474
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307003901
—
TX
01
—
TXB162093
PTAN
TX
Enumeration date
07/26/2012
Last updated
07/27/2023
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