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Organization

20/20 ICARE AND IWEAR, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LONG DO OD (MANAGING OPTOMETRIST)
(817) 262-2145
Entity
Organization

Contact information

Practice address
3510 S STATE HWY 161, SUITE 110, GRAND PRAIRIE, TX 75052
(972) 264-7200
(972) 264-7220
Mailing address
1001 RHONE LN, SOUTHLAKE, TX 76092-1449
(817) 262-2145

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8143TG
TX

Other

Enumeration date
06/21/2017
Last updated
10/27/2023
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