Individual
DR. EUGENE W. MARLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
239 W JEFFERSON BLVD, SUITE B, DALLAS, TX 75208-4510
(214) 943-7604
(214) 941-6451
Mailing address
1517 TRAMMELL DR, BENBROOK, TX 76126-3828
(817) 249-2285
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1098DT
KY
152W00000X
Optometrist
Primary
3813T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00E81S
BLUE CROSS BLUE SHIELD
TX
01
—
451997
NVA
TX
01
—
81184E
BLUE CROSS BLUE SHIELD
TX
01
—
839486
EYE MED ID NUMBER
TX
01
—
MA360100
CLARITY VISION NUMBER
TX
Enumeration date
08/09/2006
Last updated
07/09/2007
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