Healthcare Provider Details

I. General information

NPI: 1174500714
Provider Name (Legal Business Name): EYECARE PLUS HH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2005
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5323 MOUNT VIEW RD
ANTIOCH TN
37013-2308
US

IV. Provider business mailing address

5323 MOUNT VIEW RD
ANTIOCH TN
37013-2308
US

V. Phone/Fax

Practice location:
  • Phone: 615-731-8900
  • Fax: 615-731-8990
Mailing address:
  • Phone: 615-731-8900
  • Fax: 615-731-8990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: CHEYANNE MULLIS
Title or Position: CREDNETIALING MANAGER
Credential:
Phone: 615-988-5303