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General NPI Number Information
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NPI Number | 1053858241
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Entity Type | Organization
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Legal Business Name | EYESIGHT HEALTHCARE, PLLC
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Dates
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Enumeration Date | 01/25/2017
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Last Update Date | 10/01/2021
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Provider Practice Location Address
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Address Line | 4242 SOUTH ALAMEDA SUITE #18
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City | CORPUS CHRISTI
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State | TX
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Zip | 78412-4147
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Country | US
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Telephone | 361-985-9000
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Fax | 361-985-9002
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Provider Business Mailing Address
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Address Line | PO BOX 3704
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City | CORPUS CHRISTI
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State | TX
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Zip | 78463-3704
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Country | US
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Telephone | 361-985-0478
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Fax | 361-985-0966
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | ROBERT C GATES
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Credential | DO
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Telephone | 361-985-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 8082TG
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License Number State | TX
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