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General NPI Number Information
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NPI Number | 1063571867
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Entity Type | Organization
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Legal Business Name | EYECARE ASSOCIATES, INC.
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 07/09/2024
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Provider Practice Location Address
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Address Line | 2603 MOODY PKWY
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City | MOODY
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State | AL
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Zip | 35004-3062
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Country | US
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Telephone | 636-200-4393
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Fax | 205-640-2025
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Provider Business Mailing Address
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Address Line | PO BOX 207243
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City | DALLAS
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State | TX
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Zip | 75320-7255
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Country | US
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Telephone | 636-200-4393
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Fax | 636-527-0766
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JAMES WACHTER
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Credential | OD
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Telephone | 636-200-4393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | S945TA510
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License Number State | AL
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