Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 02872T | TX |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 02872T | TX |
N | 152WP0200X | Pediatric Optomitrist | 02872T | TX |
N | 152WS0006X | Sports Vision | 02872T | TX |
N | 152WX0102X | Occupational Vision | 02872T | TX |
NPI | 1114934957 |
---|---|
Provider Name | Dr. Mark Stephen Ragsdale |
First Address | Denton, TX 76201-4128 |
Second Address | Denton, TX 76201-4128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 21/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0201816-02 | (05) | TX |