Organization Name: | MAPLEWOOD EYECARE CENTER |
NPI Number: | 1629241617 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LARRY DALE GUNNELL (OPTOMETRIST) |
Mailing Address: | 3631 Maplewood Ave Suite 2 Wichita Falls |
State: | TX US |
Postal Code: | 763082149 |
Phone Number: | 9406960296 |
Fax Number: | 9406960298 |
NPI Enumeration Date: | 04/10/2008 |
NPI Last Update Date: | 04/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | 2496TG |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |