Liles Vision Clinic

LBN: C Wallace Liles Jr Od Pa
Liles Vision Clinic is an health care organization with primary practice located at 404D E Collin Raye Dr , De Queen AR 71832-4149. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. C Wallace Liles Jr Od Pa can be contacted via phone (870) 642-6900, or through Liles, C. Wallace via phone (870) 642-6900.

Contact Information

Primary practice address
404D E Collin Raye Dr De Queen AR 71832-4149
Phone: (870) 642-6900
Fax: (870) 642-4928
Website:
Map and Directions
Authorized official contact:
Name: Liles, C. Wallace Doctor of Optometry (OD)
Phone: (870) 642-6900

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X AR2331 Arkansas

Profile Details

NPI number 1316165178
LBN Legal business name C Wallace Liles Jr Od Pa
DBA Doing business as Liles Vision Clinic
Authorized official Liles, C. Wallace Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 24th, 2007
Last updated Sep 1st, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316165178 NPPES
Arkansas MEDICAID 113655722

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