Ron G Davidson, OD PC Dba Eyes Nouveau

Primary specialty

OptometristTaxonomy code 152W00000X

License

2361TG Issued in TN

Legal business name

RON G DAVIDSON, OD PC DBA EYES NOUVEAU

Practice address

3000 S Hulen St
Suite 104
Fort Worth, TX 76109-1929

Phone

(817) 738-2027

Fax

(817) 738-5440

NPI assigned

Jun 5, 2007

Organization subpart

Yes

Parent organization

RON G DAVIDSON OD PCAs reported in NPPES

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

Authorized official

Name

Dorothy C Angus

Title

Office Manager

Phone

(817) 738-2027

Specialties & licenses 1

Addresses

Part of

Ron G Davidson OD PC

Locations

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226361600000",
    "number": "1386846913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 S HULEN ST",
            "address_2": "SUITE 104",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091929",
            "telephone_number": "817-738-2027",
            "fax_number": "817-738-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 S HULEN ST",
            "address_2": "SUITE 104",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091929",
            "telephone_number": "817-738-2027",
            "fax_number": "817-738-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RON G DAVIDSON, OD PC DBA EYES NOUVEAU",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RON G DAVIDSON OD PC",
        "enumeration_date": "2007-06-05",
        "last_updated": "2008-11-11",
        "status": "A",
        "authorized_official_last_name": "ANGUS",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "817-738-2027"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2361TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Elora Ronaldes, M.ED., LPC-ASSOCIATE
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• Rooster Medical Equipment & Supplies

• Optometrist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.