Provider Demographics
NPI:1972740926
Name:JAIME HALL-MALOUF, O.D. 20/20 VISION CARE, P.C.
Entity Type:Organization
Organization Name:JAIME HALL-MALOUF, O.D. 20/20 VISION CARE, P.C.
Other - Org Name:DR. JAIME HALL-MALOUF
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:GAILE
Authorized Official - Last Name:HALL-MALOUF
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:903-873-5757
Mailing Address - Street 1:140 W JAMES ST
Mailing Address - Street 2:
Mailing Address - City:WILLS POINT
Mailing Address - State:TX
Mailing Address - Zip Code:75169-2049
Mailing Address - Country:US
Mailing Address - Phone:903-873-5757
Mailing Address - Fax:903-873-5522
Practice Address - Street 1:140 W JAMES ST
Practice Address - Street 2:
Practice Address - City:WILLS POINT
Practice Address - State:TX
Practice Address - Zip Code:75169-2049
Practice Address - Country:US
Practice Address - Phone:903-873-5757
Practice Address - Fax:903-873-5522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX06672332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1295778793OtherNPI
TX1711129-02Medicaid
TX613682Medicare PIN