20-20 Sight of Lakewood PA
Organization Active NPI Optometrist · Dallas, TX
NPI 1669816849 · NPPES record last updated Aug 1, 2014
Key facts
- NPI
- 1669816849
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 5597TG
- Legal business name
- 20-20 SIGHT OF LAKEWOOD PA
- Practice address
- 1905 Abrams Rd
Dallas, TX 75214-3916 - Phone
- (214) 821-2020
- Fax
- (972) 264-7220
- NPI assigned
- Apr 18, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. Larry Don Tarrant, D.O.
- Title
- Doctor
- Phone
- (214) 773-3457
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 5597TG | Yes |
Addresses
Primary practice location
1905 Abrams Rd
Dallas, TX 75214-3916
Mailing address
1905 Abrams Rd
Dallas, TX 75214-3916
Phone (214) 821-2020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 038437201 | Medicaid | TX | |
| 038435601 | Medicaid | TX | |
| 216013701 | Medicaid | TX |
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2014. 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.