Provider Demographics
NPI:1053876169
Name:PALO PINTO EYE CARE PLLC
Entity type:Organization
Organization Name:PALO PINTO EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:940-549-1800
Mailing Address - Street 1:2200 STATE HIGHWAY 16 S
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76450-4616
Mailing Address - Country:US
Mailing Address - Phone:940-549-1800
Mailing Address - Fax:
Practice Address - Street 1:2515 HIGHWAY 180 W STE A
Practice Address - Street 2:
Practice Address - City:MINERAL WELLS
Practice Address - State:TX
Practice Address - Zip Code:76067-8295
Practice Address - Country:US
Practice Address - Phone:940-549-1800
Practice Address - Fax:940-549-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-02
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty