Mel Rockwall LLC

NPI #1477190437 in Allen, Texas

Provider Information

NPI Number: 1477190437
Entity Type: Organization
Organization Name: Mel Rockwall LLC
Primary Specialty: Optometrist
Enumeration Date: Dec 9, 2019
Last Updated: Feb 22, 2021

Practice Location

Address: 1784 W MCDERMOTT DR STE 110
City: Allen
State: Texas
ZIP Code: 75013-3395
Phone: (561) 275-2020

Authorized Official

Name: JACKIE BENNETT
Title: CREDENTIALING SUPERVISOR
Phone: (561) 433-6009

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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