Individual
DR. TIMOTHY P KRET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4825 CAMP BOWIE BLVD, FORT WORTH, TX 76107-4150
(817) 731-4646
(817) 731-4646
Mailing address
4825 CAMP BOWIE BLVD, FORT WORTH, TX 76107-4150
(817) 731-4646
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2288TG
TX
152WC0802X
Corneal and Contact Management Optometrist
Primary
2288TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0934564
—
TX
01
—
4502490
AETNA
TX
01
—
80813Q
BCBS GROUP #0058FC
TX
Enumeration date
05/30/2005
Last updated
08/30/2016
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