Healthcare Provider Details

I. General information

NPI: 1831707603
Provider Name (Legal Business Name): LEWISVILLE EYE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2020
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 E ROUND GROVE RD
LEWISVILLE TX
75067-8301
US

IV. Provider business mailing address

2816 N UMBERLAND DR
LEWISVILLE TX
75056-5969
US

V. Phone/Fax

Practice location:
  • Phone: 214-529-6437
  • Fax:
Mailing address:
  • Phone: 214-529-6437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BINDI ASHOK DESAI
Title or Position: OWNER
Credential: OD
Phone: 214-529-6437