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General NPI Number Information
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NPI Number | 1710012877
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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 | 02/22/2007
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Last Update Date | 07/09/2024
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Provider Practice Location Address
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Address Line | 3165 GREEN VALLEY RD
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City | BIRMINGHAM
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State | AL
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Zip | 35243-5262
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Country | US
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Telephone | 636-200-4393
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Fax | 205-967-2119
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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 | DOCTOR
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Name | CHARLES K BROWN
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Credential | OD
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Telephone | 205-967-2103
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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 | S462TA018
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | SB75TA798
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | SB75TA798
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | S462TA018
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License Number State | AL
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