Dehaven Eye Clinic PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

DEHAVEN EYE CLINIC PA

Practice address

1424 E Front St
Tyler, TX 75702-8501

Phone

(903) 595-4144

Fax

(903) 526-5491

NPI assigned

Jul 15, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Gina Lowndes

Title

Financial Service Manager

Phone

(903) 595-7510

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505692800000",
    "number": "1225037955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130639",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757130639",
            "telephone_number": "903-595-7508",
            "fax_number": "903-526-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 E FRONT ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028501",
            "telephone_number": "903-595-4144",
            "fax_number": "903-526-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEHAVEN EYE CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-15",
        "last_updated": "2017-09-18",
        "status": "A",
        "authorized_official_last_name": "LOWNDES",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "FINANCIAL SERVICE MANAGER",
        "authorized_official_telephone_number": "903-595-7510",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00N57A",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120728402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vikash Deendyal
• Emily Brooke Dees
• Destani Defur
• Assefa Degu
• Dehaven Cataract Surgical Center ,Inc
• Dehaven Eye Clinic PA
• Thomas J. Dehaven, M.D.
• Deity Health Care LLC
• John Dejesus
• Anabel Del Angel

• Ophthalmology Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.