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NPI Code Detail

MEDICARE: EYECARECENTER OD PA

MEDICARE: EYECARECENTER OD PA
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
1152W00000XOptometrist

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3CA8262OTHERNCRR MEDICARE GROUP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20263NOTHERNCBCBSNC GROUP NUMBER

General Provider Information

NPI Number : 1952354458
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYECARECENTER OD PA
Provider Business Mailing Address
First Line : PO BOX 207261
Second Line :
City : DALLAS
State : TX
Zip : 75320-7261
Country : US
Telephone Number : 636-200-4393
Fax Number : 636-527-0766
Provider Business Practice Location Address
First Line : 4170 FAYETTEVILLE RD
Second Line :
City : RALEIGH
State : NC
Zip : 27603-3606
Country : US
Telephone Number : 636-200-4393
Fax Number : 919-772-8818
Authorized Official
Title or Position : OWNER
Name : DR. ALISON BAILEY
Credential : OD
Telephone Number : 636-200-4393
Provider Enumeration Date : 05/18/2006
Last Update Date : 09/29/2023

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Directions to “EYECARECENTER OD PA ” Practice Location

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