Provider Demographics
NPI:1912450164
Name:ALLIANCE OPHTHALMOLOGY, PLLC
Entity Type:Organization
Organization Name:ALLIANCE OPHTHALMOLOGY, PLLC
Other - Org Name:ALLIANCE VISION INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:BOYD
Authorized Official - Last Name:STRANGE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-442-2020
Mailing Address - Street 1:9429 N BEACH ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-9059
Mailing Address - Country:US
Mailing Address - Phone:817-442-2020
Mailing Address - Fax:682-499-3856
Practice Address - Street 1:9429 N BEACH ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-9059
Practice Address - Country:US
Practice Address - Phone:817-442-2020
Practice Address - Fax:682-499-3856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-24
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP9009207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty