Elk Vision Holdings LLC

NPI #1619264090 in Emory, Texas

Provider Information

NPI Number: 1619264090
Entity Type: Organization
Organization Name: Elk Vision Holdings LLC
Primary Specialty: Optometrist
Enumeration Date: Jul 6, 2011
Last Updated: Jul 6, 2011

Practice Location

Address: 886 E LENNON DR STE 102
City: Emory
State: Texas
ZIP Code: 75440-3216
Phone: (903) 474-9090

Authorized Official

Name: ERIC LEE KETCHUM, O.D.
Title: OWNER
Phone: (903) 474-9090

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist - Corneal and Contact Management — Corneal and Contact Management	152WC0802X
Optometrist - Low Vision Rehabilitation — Low Vision Rehabilitation	152WL0500X
Optometrist - Pediatrics — Pediatrics	152WP0200X
Optometrist - Sports Vision — Sports Vision	152WS0006X
Optometrist - Vision Therapy — Vision Therapy	152WV0400X
Optometrist - Occupational Vision — Occupational Vision	152WX0102X
Optometrist	152W00000X	Primary

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