MEDICARE: EYEAR OPTICAL, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier	0692	TN

General Provider Information

NPI Number	:	1255306742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYEAR OPTICAL, INC

Provider Business Mailing Address
First Line	:	5301 HIGHWAY 153
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-4912
Country	:	US
Telephone Number	:	423-877-9990
Fax Number	:	423-875-9952

Provider Business Practice Location Address
First Line	:	5301 HIGHWAY 153
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-4912
Country	:	US
Telephone Number	:	423-877-9990
Fax Number	:	423-875-9952

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CINDY C HENDERSON
Credential	:	LDO
Telephone Number	:	423-875-9945

Provider Enumeration Date	:	02/20/2006
Last Update Date	:	08/22/2020

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Directions to “EYEAR OPTICAL, INC ” Practice Location

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