Organization
TEXAS RETINA ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFEREY BROCKETTE (CEO)
(214) 692-6941
Entity
Organization
Contact information
Practice address
1708 COIT RD, SUITE 215, PLANO, TX 75075-5024
(972) 596-9222
Mailing address
PO BOX 650037, DALLAS, TX 75265-0037
(214) 696-2008
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
094850704
—
TX
Enumeration date
08/07/2006
Last updated
05/16/2023
Update your record
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