East Texas Eye Care Associates PLLC

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

EAST TEXAS EYE CARE ASSOCIATES PLLC

Practice address

305 W Rusk St
Jacksonville, TX 75766-2337

Phone

(903) 586-9611

Fax

(903) 586-1171

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. June Cheatham

Title

Administrator

Phone

(903) 595-0500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Optical Shop Doing business as

Locations

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705881600000",
    "number": "1689690265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 E 5TH ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013525",
            "telephone_number": "903-595-0500",
            "fax_number": "903-595-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W RUSK ST",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757662337",
            "telephone_number": "903-586-9611",
            "fax_number": "903-586-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS EYE CARE ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A",
        "authorized_official_last_name": "CHEATHAM",
        "authorized_official_first_name": "JUNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "903-595-0500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085828403",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Optical Shop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah Dubose
• Roxanne D. Dudley, RN, PMHNP-BC, LPC
• Callie Elizabeth Dunkerson, MS, RD, LD
• Mikayle Anne Durant, APRN
• Ryan Earle, NP
• East Texas Medical Center Healthcare Associates
• East Texas Medical Center Jacksonville
• East Texas Medical Center Jacksonville
• Ruth S Eckenrod, PTA
• Edge Medical Supply, LLC

• All providers in Jacksonville, TX
• Optician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.