Basic Information
| Provider Information | |||||||||
| NPI: | 1699404129 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ONE HOUR OPTICAL MEDICAL SERVICES, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 E CAMPBELL ROAD | ||||||||
| Address2: | SUITE 108 PMB 679402 | ||||||||
| City: | RICHARDSON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750811962 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6184629818 | ||||||||
| FaxNumber: | 3147414947 | ||||||||
| Practice Location | |||||||||
| Address1: | 712 WHALERS WAY STE A210 | ||||||||
| Address2: | |||||||||
| City: | FORT COLLINS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805253621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702827739 | ||||||||
| FaxNumber: | 9702266654 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2022 | ||||||||
| LastUpdateDate: | 06/09/2022 | ||||||||
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| AuthorizedOfficialLastName: | HIEB | ||||||||
| AuthorizedOfficialFirstName: | STACY | ||||||||
| AuthorizedOfficialMiddleName: | LYNN | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3034874432 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.