Fenton, Elvin W
Fenton, Elvin W is an sole proprietor health care provider with primary practice located at 751 Mid Cities Blvd , Hurst TX 76054-2748. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Fenton, Elvin W can be contacted via phone (817) 656-2020.Contact Information
Primary practice address
751 Mid Cities Blvd
Hurst TX 76054-2748
Phone: (817) 656-2020
Fax: (817) 656-5908
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 5241 | Texas |
Profile Details
| NPI number | 1215920442 |
|---|---|
| LBN Legal business name | Fenton, Elvin W |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 23rd, 2005 |
| Last updated | Apr 7th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215920442 | NPPES |
| Texas | MEDICAID | 0193336-01 | |
| Texas | MEDICAID | 134244722 | |
| Texas | Other | 97883 | |
| Texas | Other | 83324E |
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