Provider Demographics
| NPI: | 1386918860 |
|---|---|
| Name: | SUNNY M. FIELD, O.D., F.A.A.O., P.A. |
| Entity type: | Organization |
| Organization Name: | SUNNY M. FIELD, O.D., F.A.A.O., P.A. |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OPTOMETRIST/OWNER |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | SUNNY |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | FIELD |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 310-592-3161 |
| Mailing Address - Street 1: | 153 YORKSHIRE DR |
| Mailing Address - Street 2: | |
| Mailing Address - City: | HEATH |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 75032-6648 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 1225 STATE HIGHWAY 276 |
| Practice Address - Street 2: | |
| Practice Address - City: | ROCKWALL |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 75032-9376 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 972-772-1613 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2012-03-01 |
| Last Update Date: | 2012-03-01 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| TX | 7304T | 152W00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Single Specialty |