Organization
TEXARKANA EYE ASSOCIATES-BROKEN BOW BRANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELVIN W FENTON OD (OWNER)
(903) 838-0783
Entity
Organization
Contact information
Practice address
511 S PARK DR, SUITE A, BROKEN BOW, OK 74728-5329
(580) 584-3434
Mailing address
2703 RICHMOND RD, TEXARKANA, TX 75503-2328
(903) 838-0783
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
OK
Other
Enumeration date
01/18/2016
Last updated
10/03/2016
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