Organization
RANDALL L TEAGUE OD PA
Active
Other names
Teague Vision Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL L TEAGUE O.D. (OPTOMETRIST / OWNER)
(501) 224-7056
Entity
Organization
Contact information
Practice address
11115 HERMITAGE RD, LITTLE ROCK, AR 72211-3807
(501) 224-7056
(501) 224-4327
Mailing address
11115 HERMITAGE RD, LITTLE ROCK, AR 72211-3807
(501) 224-7056
(501) 224-4327
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2254
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105488722
—
AR
Enumeration date
08/30/2010
Last updated
08/30/2010
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