Individual
CHI DO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1515 N TOWN EAST BLVD STE 173, MESQUITE, TX 75150-4142
(469) 608-2654
Mailing address
4740 MEADOWVIEW DR, MESQUITE, TX 75150-2951
(214) 516-8549
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9683
TX
Other
Enumeration date
06/09/2019
Last updated
06/09/2019
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