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General NPI Number Information
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NPI Number | 1932411428
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Entity Type | Organization
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Legal Business Name | THE EYE CENTER INC
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Dates
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Enumeration Date | 07/13/2010
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Last Update Date | 07/13/2010
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Provider Practice Location Address
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Address Line | 900 N HWY 67
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City | FLORISSANT
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State | MO
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Zip | 63031-2919
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Country | US
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Telephone | 314-838-0300
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Fax | 314-838-4682
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Provider Business Mailing Address
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Address Line | 4750 MEXICO ROAD SUITE 200
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City | ST PETERS
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State | MO
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Zip | 63376-1668
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Country | US
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Telephone | 636-441-1200
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Fax | 636-442-5017
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Authorized Official
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Title or Position | MD PRESIDENT
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Name | DR. JOHN P GOLTSCHMAN
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Credential | MD
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Telephone | 314-838-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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