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NPI Code Detail

MEDICARE: TEXARKANA EYE ASSOCIATES

MEDICARE: TEXARKANA EYE ASSOCIATES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist5241TTX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18P157OTHERARAR BCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
300E39YOTHERTXBCBS GROUP NUMBER
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205909272
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEXARKANA EYE ASSOCIATES
Provider Business Mailing Address
First Line : 2703 RICHMOND RD
Second Line :
City : TEXARKANA
State : TX
Zip : 75503-2328
Country : US
Telephone Number : 903-838-0783
Fax Number : 903-831-6145
Provider Business Practice Location Address
First Line : 2703 RICHMOND RD
Second Line :
City : TEXARKANA
State : TX
Zip : 75503-2328
Country : US
Telephone Number : 903-838-0783
Fax Number : 903-831-6145
Authorized Official
Title or Position : DOCTOR
Name : DR. ELVIN W FENTON
Credential : OD
Telephone Number : 903-838-0783
Provider Enumeration Date : 11/16/2006
Last Update Date : 09/30/2011

Similar Medicare Providers

1588382725 — SONALI DAS OD
Practice Location Address:
2703 RICHMOND RD
TEXARKANA, TX
75503-2328
Practice Phone: 903-838-0783
Practice Fax: 903-831-6145
1598899379 — DR. THOMAS MERLE DVORAK O.D.
Practice Location Address:
2703 RICHMOND RD
TEXARKANA, TX
75503-2328
Practice Phone: 903-838-0783
Practice Fax: 903-831-6145
1598107716 — DR. NEHAD M VIRANI O.D.
Practice Location Address:
2703 RICHMOND RD
TEXARKANA, TX
75503-2328
Practice Phone: 903-838-0783
Practice Fax: 903-831-6145
1427413558 — TEXARKANA EYE ASSOCIATES
Practice Location Address:
2703 RICHMOND RD
TEXARKANA, TX
75503-2328
Practice Phone: 903-838-0783
Practice Fax:
1639613979 — JACK GREENAN
Practice Location Address:
2703 RICHMOND RD
TEXARKANA, TX
75503-2328
Practice Phone: 903-838-0783
Practice Fax:
1134649015 — DR. PRISCILLA KIER OD
Practice Location Address:
2703 RICHMOND RD
TEXARKANA, TX
75503-2328
Practice Phone: 903-838-0783
Practice Fax: 903-838-0783

Directions to “TEXARKANA EYE ASSOCIATES ” Practice Location

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