Canadian Eyecare Clinic, P.C.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

4674T Issued in TX

Legal business name

CANADIAN EYECARE CLINIC, P.C.

Practice address

306 Main St
Canadian, TX 79014-2215

Phone

(806) 323-8484

NPI assigned

Aug 11, 2006

Last updated

Mar 22, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert LuskNPI 1902817927

Title

Owner

Phone

(806) 323-8484

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Glynn Lusk, O.D.

  • Optometrist
  • Canadian, TX
  • NPI 1902817927
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300752000000",
    "number": "1285645218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 MAIN ST",
            "city": "CANADIAN",
            "state": "TX",
            "postal_code": "790142215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 MAIN ST",
            "city": "CANADIAN",
            "state": "TX",
            "postal_code": "790142215",
            "telephone_number": "806-323-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANADIAN EYECARE CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2011-03-22",
        "status": "A",
        "authorized_official_last_name": "LUSK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "806-323-8484",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "4674T",
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OK",
            "license": "2073",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143542201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tasha Kate Butler, APRN-CNP
• Canadian Family Physicians, PLLC
• Canadian Isd
• Canadian Pharmacy Management LLC (Medic Pharmacy and Gifts)
• James Clifford Chappell
• George A Cook, MD

• Clinic/Center in Canadian, TX
• Providers in Canadian, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.