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Individual

ANTHONY PETER BORGOGNONI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1900 PRESTON RD, SUITE 265, PLANO, TX 75093-5175
(972) 519-0006
(972) 519-0669
Mailing address
3307 WELLS DR, PLANO, TX 75093-6634
(214) 718-4848

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3409TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100742901
MEDICAID
TX
01
60103017
DPS
Enumeration date
06/06/2006
Last updated
03/07/2023
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