Healthcare Provider Details

I. General information

NPI: 1568227973
Provider Name (Legal Business Name): PLANO EYE CARE SURGERY CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5280 TOWNE SQUARE DR
PLANO TX
75024-0037
US

IV. Provider business mailing address

5280 TOWNE SQUARE DR
PLANO TX
75024-0037
US

V. Phone/Fax

Practice location:
  • Phone: 214-380-2020
  • Fax:
Mailing address:
  • Phone: 214-380-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LUKE REBENITSCH
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 214-380-2020