Provider Demographics
NPI:1457513343
Name:DOUGLAS N. BLACK, O.D., P.A.
Entity Type:Organization
Organization Name:DOUGLAS N. BLACK, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-234-3937
Mailing Address - Street 1:2000 N PLANO RD
Mailing Address - Street 2:STE 111
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-4427
Mailing Address - Country:US
Mailing Address - Phone:972-234-3937
Mailing Address - Fax:972-234-3982
Practice Address - Street 1:2000 N PLANO RD
Practice Address - Street 2:STE 111
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-4427
Practice Address - Country:US
Practice Address - Phone:972-234-3937
Practice Address - Fax:972-234-3982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty