Provider Demographics
NPI:1710028733
Name:KING, RONALD ORVILLE (O D)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:ORVILLE
Last Name:KING
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6331 KNOLL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75249-3827
Mailing Address - Country:US
Mailing Address - Phone:972-296-2109
Mailing Address - Fax:972-296-2109
Practice Address - Street 1:215 W CAMP WISDOM RD
Practice Address - Street 2:SUITE 106
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-3340
Practice Address - Country:US
Practice Address - Phone:972-296-2109
Practice Address - Fax:972-296-2109
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2240152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist