Individual
DR. KELBY ATKINS TRUSTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3111 UNICORN LAKE BLVD, STE 100, DENTON, TX 76210-0117
(940) 891-3937
(940) 591-8368
Mailing address
3111 UNICORN LAKE BLVD STE 100, DENTON, TX 76210-0118
(940) 891-3937
(940) 591-8368
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3995TG
TX
152WC0802X
Corneal and Contact Management Optometrist
3995TG
TX
152WS0006X
Sports Vision Optometrist
3995TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0178390001
MEDICARE - PALMETTO DME
TX
05
—
019328601
—
TX
01
—
3995TG
OD LICENSE NUMBER
TX
01
—
80236Q
BCBS
TX
Enumeration date
12/14/2005
Last updated
03/17/2018
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