MEDICARE: HEALTHCARE EYE CLINIC 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	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1992059331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHCARE EYE CLINIC INC

Provider Business Mailing Address
First Line	:	4801 S BUCKNER BLVD
Second Line	:	SUITE 700
City	:	DALLAS
State	:	TX
Zip	:	75227-2373
Country	:	US
Telephone Number	:	972-232-9075
Fax Number	:

Provider Business Practice Location Address
First Line	:	4801 S BUCKNER BLVD
Second Line	:	SUITE 700
City	:	DALLAS
State	:	TX
Zip	:	75227-2373
Country	:	US
Telephone Number	:	972-232-9075
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HENRY JOSE GREYNER
Credential	:
Telephone Number	:	972-232-9075

Provider Enumeration Date	:	11/07/2012
Last Update Date	:	11/07/2012

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