Organization
MIDLAND EYE NETWORK,LLP
Active
Other names
Laser Network
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFF GRIGSBY O.D. (OPTOMETRIST)
(432) 694-5259
Entity
Organization
Contact information
Practice address
4109 N MIDLAND DR, MIDLAND, TX 79707-3500
(432) 559-2227
Mailing address
4109 N MIDLAND DR, MIDLAND, TX 79707-3500
(432) 559-2227
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
2219TG
TX
152WC0802X
Corneal and Contact Management Optometrist
Primary
3040TG
TX
152WC0802X
Corneal and Contact Management Optometrist
3317TG
TX
152WC0802X
Corneal and Contact Management Optometrist
3896TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2219TG
OPTOMETRY LICENSE 2 COOK
TX
01
—
3040TG
OPTOMETRY LICENSE
TX
01
—
3317TG
OPTOMETRY LICENSE 3 NEELY
TX
01
—
3896TG
OPTOMETRY LICENSE 4 SHEETS
TX
Enumeration date
06/24/2009
Last updated
06/24/2009
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