Organization
LAKE RIDGE EYE CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROLYN KHA O.D. (OWNER)
(972) 641-5900
Entity
Organization
Contact information
Practice address
4927 LAKE RIDGE PKWY, STE. 160, GRAND PRAIRIE, TX 75052-3073
(972) 641-5900
(972) 641-5903
Mailing address
4927 LAKE RIDGE PKWY, STE. 160, GRAND PRAIRIE, TX 75052-3073
(972) 641-5900
(972) 641-5903
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6592TG
TX
Other
Enumeration date
10/11/2006
Last updated
08/22/2020
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