Basic Information
Provider Information
NPI: 1386689081
EntityType: 2
ReplacementNPI:  
OrganizationName: MAY & HETTLER, O.D., PLLC
LastName:  
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Mailing Information
Address1: PO BOX 208869
Address2:  
City: DALLAS
State: TX
PostalCode: 753208869
CountryCode: US
TelephoneNumber: 6362004393
FaxNumber: 6365270766
Practice Location
Address1: 6098 FRANCONIA RD
Address2:  
City: ALEXANDRIA
State: VA
PostalCode: 223101742
CountryCode: US
TelephoneNumber: 7039710544
FaxNumber: 7037197627
Other Information
ProviderEnumerationDate: 06/17/2006
LastUpdateDate: 07/14/2022
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: WACHTER
AuthorizedOfficialFirstName: JAMES
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AuthorizedOfficialTitleorPosition: CMO
AuthorizedOfficialTelephone: 6362004393
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate: 07/14/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000X0618000063VAY193400000X SINGLE SPECIALTY GROUPEye and Vision Services ProvidersOptometrist 

No ID Information.


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