Advanced Eyelid Surgery Center & Laser Center

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

J5739 Issued in TX

Legal business name

ADVANCED EYELID SURGERY CENTER & LASER CENTER

Practice address

6407 Colleyville Blvd
Suite B
Colleyville, TX 76034-6228

Phone

(817) 329-4480

Fax

(817) 488-5993

NPI assigned

Jan 7, 2008

Organization subpart

Yes

Parent organization

ADVANCED EYELID SURGERY CENTER & LASER CENTERAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mayli L Davis, M.D.

Title

Doctor

Phone

(817) 329-4480

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Advanced Eyelid Surgery Center & Laser Center Other name

Part of

Advanced Eyelid Surgery

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1285819474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6407 COLLEYVILLE BLVD",
            "address_2": "SUITE B",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760346228",
            "telephone_number": "817-329-4480",
            "fax_number": "817-488-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6407 COLLEYVILLE BLVD",
            "address_2": "SUITE B",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760346228",
            "telephone_number": "817-329-4480",
            "fax_number": "817-488-5993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED EYELID SURGERY CENTER & LASER CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED EYELID SURGERY CENTER & LASER CENTER",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MAYLI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "817-329-4480",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "J5739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0067EZ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127504201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Eyelid Surgery Center & Laser Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Adel a Zakhary MD PA
• Enitan Adetunji Adesanoye, M.D.
• Adrienne L. Prentiss, MD PA
• Adrienne L. Prentiss, MD PA
• Advanced Dental Imaging Center
• Advantage Geriatric Care PA
• Advocare Family Services, LLC
• Affinity Smiles Dental, PLLC
• Agile Health Investment PLLC
• Rene Aguilar

• Ophthalmology Physician in Colleyville, TX
• Providers in Colleyville, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.