Healthcare Provider Details

I. General information

NPI: 1821614033
Provider Name (Legal Business Name): RMO EYECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2020
Last Update Date: 06/23/2020
Certification Date: 06/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2756 S BROADWAY AVE
TYLER TX
75701-5412
US

IV. Provider business mailing address

2756 S BROADWAY AVE
TYLER TX
75701-5412
US

V. Phone/Fax

Practice location:
  • Phone: 903-593-2345
  • Fax: 903-593-4646
Mailing address:
  • Phone: 903-593-2345
  • Fax: 903-593-4646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. DAVID MICHAEL JOHNSON
Title or Position: OPTOMETRIST
Credential: OD
Phone: 903-593-2345