Southlake Eye Associates, PA

NPI #1801966528 in Southlake, Texas

Provider Information

NPI Number: 1801966528
Entity Type: Organization
Organization Name: Southlake Eye Associates, PA
Primary Specialty: Optometrist
Enumeration Date: Nov 9, 2006
Last Updated: Jun 21, 2018

Practice Location

Address: 101 RIVER OAKS DR
Address 2: STE 100
City: Southlake
State: Texas
ZIP Code: 76092
Phone: (817) 562-2101

Authorized Official

Name: DR. GREGORY B KLOESEL, O.D.
Title: PRESIDENT OPTOMETRIST
Phone: (817) 562-2101

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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