Provider Demographics
NPI:1477805729
Name:GENE, DAMON CRANE (OD)
Entity Type:Individual
Prefix:
First Name:DAMON
Middle Name:CRANE
Last Name:GENE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2959 S BUCKNER BLVD
Mailing Address - Street 2:STE 700
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-6950
Mailing Address - Country:US
Mailing Address - Phone:214-239-2176
Mailing Address - Fax:214-239-2177
Practice Address - Street 1:3400 COIT RD
Practice Address - Street 2:#261570
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-3771
Practice Address - Country:US
Practice Address - Phone:805-824-7276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT14430152W00000X
TX8085TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist