Organization
PEDIATRIC EYECARE OF NORTH TEXAS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA SURRATT (CREDENTIALING COORDINATOR)
(972) 258-7979
Entity
Organization
Contact information
Practice address
3200 N MACARTHUR BLVD STE 200, IRVING, TX 75062-4404
(972) 258-7979
(972) 570-5502
Mailing address
3200 N MACARTHUR BLVD STE 200, IRVING, TX 75062-4404
(972) 258-7979
(972) 570-5502
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
152WP0200X
Pediatric Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
—
—
Other
Enumeration date
07/28/2023
Last updated
07/28/2023
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