Provider Demographics
NPI:1447239538
Name:DALLAS OPHTHALMOLOGY CENTER INC
Entity Type:Organization
Organization Name:DALLAS OPHTHALMOLOGY CENTER INC
Other - Org Name:CRNA GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:POINTS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-520-7600
Mailing Address - Street 1:4633 NORTH CENTRAL EXPRESSWAY
Mailing Address - Street 2:STE 310
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-4022
Mailing Address - Country:US
Mailing Address - Phone:214-520-7600
Mailing Address - Fax:214-520-6522
Practice Address - Street 1:4633 NORTH CENTRAL EXPRESSWAY
Practice Address - Street 2:STE 310
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-4022
Practice Address - Country:US
Practice Address - Phone:214-520-7600
Practice Address - Fax:214-520-6522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
87521CMedicare ID - Type Unspecified