Provider Demographics
NPI:1700101243
Name:DR. MASSALA REFFELL, O.D., PLLC
Entity Type:Organization
Organization Name:DR. MASSALA REFFELL, O.D., PLLC
Other - Org Name:I
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MASSALA
Authorized Official - Middle Name:
Authorized Official - Last Name:REFFELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-989-2424
Mailing Address - Street 1:6760 WESTWORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTWORTH VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:76114-4002
Mailing Address - Country:US
Mailing Address - Phone:817-989-2424
Mailing Address - Fax:817-989-2427
Practice Address - Street 1:6760 WESTWORTH BLVD
Practice Address - Street 2:
Practice Address - City:WESTWORTH VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:76114-4002
Practice Address - Country:US
Practice Address - Phone:817-989-2424
Practice Address - Fax:817-989-2427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-27
Last Update Date:2010-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX06876TG152W00000X, 152WC0802X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Single Specialty