Organization
DE SOTO EYE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS J MC GUIRE JR. OD (OPTOMETRIST)
(636) 586-5406
Entity
Organization
Contact information
Practice address
126 S MAIN ST, DE SOTO, MO 63020-2104
(636) 586-5406
(636) 586-1969
Mailing address
126 S MAIN ST, DE SOTO, MO 63020-2104
(636) 586-5406
(636) 586-1969
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
T02872
MO
152W00000X
Optometrist
Primary
T03075
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
313299505
—
MO
05
—
315698803
—
MO
Enumeration date
06/16/2008
Last updated
07/15/2009
Update your record
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