Individual
ALICE SEAVON BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OPTHALMIC ASSISTANT
Contact information
Practice address
428 CENTENNIAL PKWY, TYLER, TX 75703-7166
(903) 266-5900
(903) 266-5914
Mailing address
428 CENTENNIAL PKWY, TYLER, TX 75703-7166
(903) 266-5990
(903) 266-5970
Taxonomy
Speciality
Code
Description
License number
State
156FX1101X
Ophthalmic Assistant
Primary
190956
TX
Other
Enumeration date
11/27/2024
Last updated
11/27/2024
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