Healthcare Provider Details

I. General information

NPI: 1740200518
Provider Name (Legal Business Name): EYE CARE PLUS LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 03/27/2022
Certification Date: 03/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5221 S COULTER ST
AMARILLO TX
79119-6676
US

IV. Provider business mailing address

7200 SW 45TH AVE SUITE 9
AMARILLO TX
79109-5084
US

V. Phone/Fax

Practice location:
  • Phone: 806-358-3594
  • Fax: 806-457-1660
Mailing address:
  • Phone: 806-358-3594
  • Fax: 806-457-1660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. JAYA PATHAPATI
Title or Position: OWNER
Credential: O.D.
Phone: 806-358-3594