Individual
DR. JERRY L ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3159 S GARLAND AVE, 511B, GARLAND, TX 75041-4000
(972) 840-1776
(972) 840-1886
Mailing address
10442 LIPPITT AVE, DALLAS, TX 75218-2251
(972) 840-1776
(972) 840-1886
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2081T
TX
Other
Enumeration date
11/15/2006
Last updated
07/09/2007
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