Individual
BRIAN MICHAEL CELICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
7150 GREENVILLE AVE, SUITE 305, DALLAS, TX 75231-5185
(214) 265-1111
(214) 265-1189
Mailing address
7150 GREENVILLE AVE, SUITE 305, DALLAS, TX 75231-5185
(214) 265-1111
(214) 265-1189
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3455TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019461501
—
TX
Enumeration date
11/18/2005
Last updated
02/03/2016
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