Individual
GREGG DUISTERMARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1201 MEDICAL PLAZA CT, GRANBURY, TX 76048-5684
(817) 279-9044
(817) 573-6234
Mailing address
1201 MEDICAL PLAZA CT, GRANBURY, TX 76048-5684
(817) 279-9044
(817) 573-6234
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7368TG
TX
Other
Enumeration date
01/20/2007
Last updated
08/20/2013
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