Aeg 5 TX Professional, PLLC
Organization Active NPI Optometrist · Coppell, TX
NPI 1992567010 · NPPES record last updated Jan 24, 2024
Key facts
- NPI
- 1992567010
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- AEG 5 TX PROFESSIONAL, PLLC
- Practice address
- 541 E Sandy Lake Rd
Coppell, TX 75019-3090 - Phone
- (972) 393-3937
- Fax
- (314) 741-4947
- NPI assigned
- Jan 24, 2024
- Organization subpart
- No
Authorized official
- Name
- Melissa Allison
- Title
- Sr. Dir. MVC
- Phone
- (618) 462-9818
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
541 E Sandy Lake Rd
Coppell, TX 75019-3090
Mailing address
111 E 4TH St Ste 440
Alton, IL 62002-6206
Phone (618) 462-9818
Other practice location 1
670 E Southlake Blvd
Southlake, TX 76092-6236
Phone (817) 329-6466
Other practice location 2
2111 Kirkwood Blvd Ste 100
Southlake, TX 76092-1461
Phone (817) 416-2010
Other providers in Coppell, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2024. 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.