Provider Demographics
NPI:1275182032
Name:TRUE EYE CENTER OF KELLER, PLLC
Entity Type:Organization
Organization Name:TRUE EYE CENTER OF KELLER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHABREE
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS CALEB
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-428-4488
Mailing Address - Street 1:4909 GOLDEN TRIANGLE BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-4480
Mailing Address - Country:US
Mailing Address - Phone:405-414-2178
Mailing Address - Fax:
Practice Address - Street 1:4909 GOLDEN TRIANGLE BLVD STE 211
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-4480
Practice Address - Country:US
Practice Address - Phone:817-428-4488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-05
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty