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Organization

PROVIDENT EYE SPECIALISTS, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEAK CHY KHAUV MD (OWNER)
(915) 240-9198
Entity
Organization

Contact information

Practice address
11212 MONTWOOD DR, EL PASO, TX 79936-4241
(915) 595-4300
(915) 595-4301
Mailing address
11212 MONTWOOD DR, EL PASO, TX 79936-4241
(915) 595-4300
(915) 595-4301

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
TX

Other

Enumeration date
10/23/2013
Last updated
05/01/2024
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