Matt Miller Od PA

NPI #1720377864 in Fort Worth, Texas

Provider Information

NPI Number: 1720377864
Entity Type: Organization
Organization Name: Matt Miller Od PA
Primary Specialty: Optometrist
Enumeration Date: Mar 29, 2011
Last Updated: Dec 9, 2011

Practice Location

Address: 3963 BOAT CLUB RD
City: Fort Worth
State: Texas
ZIP Code: 76135-3202
Phone: (817) 237-7153

Authorized Official

Name: PATSY L PAYNE
Title: OFFICE MANAGER
Phone: (817) 406-4362

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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