Organization Name: | EAST TEXAS EYE CARE ASSOCIATES LLC |
NPI Number: | 1780600346 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JUNE CHEATHAM (ADMINISTRATOR) |
Mailing Address: | 1440 S Main St Lindale |
State: | TX US |
Postal Code: | 757716267 |
Phone Number: | 9038828990 |
Fax Number: | 9038824476 |
NPI Enumeration Date: | 07/15/2006 |
NPI Last Update Date: | 05/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |