East Texas Eye Care Associates PLLC
Organization Active NPI Optician · Lindale, TX
NPI 1780600346 · NPPES record last updated Jan 22, 2024
Key facts
- NPI
- 1780600346
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optician 156FX1800X
- Legal business name
- EAST TEXAS EYE CARE ASSOCIATES PLLC
- Practice address
- 1440 S Main St
Lindale, TX 75771-6267 - Phone
- (903) 882-8990
- Fax
- (903) 882-4476
- NPI assigned
- Jul 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. June Cheatham
- Title
- Administrator
- Phone
- (903) 595-0500
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 3
Practitioners 12
-
Thomas Bochow, M.D., M.P.H.
-
Troy B Cooper, O.D.
-
Joshua S Hooper, OD
-
Gregory D Kiblinger, M.D.
-
Austin Thomas Lash, M.D.
-
Curtis Jeffrey Pennell, M.D.
-
John S Whorff, O.D.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| The Optical Shop |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930010024 | TX | DME Supplier - Physician - Optometrist | 2567454085 | Practice locations: Lindale, TX |
National Provider Directory
- Tax ID family
- Jerry a Parrish MD Asso
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician |
156FX1800X | Yes |
Addresses
Primary practice location
1440 S Main St
Lindale, TX 75771-6267
Mailing address
2440 E 5TH St
Tyler, TX 75701-3525
Phone (903) 595-0500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 085828402 | Medicaid | TX |
Other names
- The Optical Shop
Other providers in Lindale, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.