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
Fax: (817) 656-5908
Website:

Health care specialties

SpecialtyCodeLicense #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 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215920442 NPPES
Texas MEDICAID 0193336-01
Texas MEDICAID 134244722
Texas Other 97883
Texas Other 83324E

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