Basic Information
Provider Information
NPI: 1225794449
EntityType: 2
ReplacementNPI:  
OrganizationName: TN DOCTORS OF OPTOMETRY, PLLC
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Mailing Information
Address1: 175 E HOUSTON STREET
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782052255
CountryCode: US
TelephoneNumber: 8003400129
FaxNumber: 2105246587
Practice Location
Address1: 254 INDIAN LAKE BLVD
Address2: SUITE 100
City: HENDERSONVILLE
State: TN
PostalCode: 370756354
CountryCode: US
TelephoneNumber: 6158220446
FaxNumber: 6152644837
Other Information
ProviderEnumerationDate: 11/11/2021
LastUpdateDate: 01/19/2022
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AuthorizedOfficialLastName: MCDONALD
AuthorizedOfficialFirstName: DOLSIE
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AuthorizedOfficialTitleorPosition: MANAGER
AuthorizedOfficialTelephone: 7264444148
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate: 01/19/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332H00000X  Y SuppliersEyewear Supplier (Equipment, not the service) 

No ID Information.


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