Individual
DR. DREW DORAN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4524 S BROADWAY AVE, TYLER, TX 75703-1305
(903) 581-1530
(903) 534-8629
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5114
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25286
OPTICARE CHIPS
TX
Enumeration date
10/26/2006
Last updated
10/10/2024
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