MEDICARE: EYE ASSOCIATES, INC

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
1	152W00000X	Optometrist	2618TG	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578776977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE ASSOCIATES, INC

Provider Business Mailing Address
First Line	:	2311 SCURRY ST
Second Line	:
City	:	BIG SPRING
State	:	TX
Zip	:	79720-5552
Country	:	US
Telephone Number	:	432-263-2501
Fax Number	:	432-263-6883

Provider Business Practice Location Address
First Line	:	2311 SCURRY ST
Second Line	:
City	:	BIG SPRING
State	:	TX
Zip	:	79720-5552
Country	:	US
Telephone Number	:	432-263-2501
Fax Number	:	432-263-6883

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN MARSHALL
Credential	:	O.D.
Telephone Number	:	432-263-2501

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	10/04/2010

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Directions to “EYE ASSOCIATES, INC ” Practice Location

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