Organization
ELK VISION HOLDINGS LLC
Active
Other names
Vision Site
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC LEE KETCHUM O.D. (OWNER)
(903) 474-9090
Entity
Organization
Contact information
Practice address
886 E LENNON DR STE 102, EMORY, TX 75440-3216
(903) 474-9090
(903) 474-9111
Mailing address
886 E LENNON DR STE 102, EMORY, TX 75440-3216
(903) 474-9090
(903) 474-9111
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7878T
TX
152WC0802X
Corneal and Contact Management Optometrist
7878T
TX
152WL0500X
Low Vision Rehabilitation Optometrist
7878T
TX
152WP0200X
Pediatric Optometrist
7878T
TX
152WS0006X
Sports Vision Optometrist
7878T
TX
152WV0400X
Vision Therapy Optometrist
7878T
TX
152WX0102X
Occupational Vision Optometrist
7878T
TX
Other
Enumeration date
07/06/2011
Last updated
07/06/2011
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