Kelli Bishop, O.D
Individual provider Active NPI Optometrist · Graham, TX
NPI 1669587143 · NPPES record last updated Sep 17, 2012
Key facts
- NPI
- 1669587143
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 8043T (TX)
- Practice address
- 1529 380 Byp
Graham, TX 76450-2323 - Phone
- (940) 549-1621
- NPI assigned
- Aug 21, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1683DT | KY | |
| Optometrist | 152W00000X | 8043T | TX | Yes |
Addresses
Primary practice location
1529 380 Byp
Graham, TX 76450-2323
Mailing address
907 Brazos St
Graham, TX 76450-3905
Phone (940) 521-8552
Other providers in Graham, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.