Organization
T D VENTURES INC.
Active
Other names
Deatherage Certified Opticians
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY ERIC DEATHERAGE FNAO ABOC (OWNER)
(940) 723-7241
Entity
Organization
Contact information
Practice address
2916 GARNETT AVE, WICHITA FALLS, TX 76308-1002
(940) 723-7241
(940) 761-2025
Mailing address
2916 GARNETT AVE, WICHITA FALLS, TX 76308-1002
(940) 723-7241
(940) 761-2025
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
TX
Other
Enumeration date
01/04/2008
Last updated
01/25/2011
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