Organization
MIDWAY EYE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBORAH ANN BROUSSARD O.D. (OPTOMETRIST)
(972) 801-2727
Entity
Organization
Contact information
Practice address
3405 MIDWAY RD, SUITE 421, PLANO, TX 75093-8138
(972) 801-2727
(972) 943-3485
Mailing address
3405 MIDWAY RD, SUITE 421, PLANO, TX 75093-8138
(972) 801-2727
(972) 943-3485
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
6060TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0081FB
BCBS GROUP
TX
Enumeration date
11/05/2007
Last updated
11/07/2007
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