Provider Demographics
NPI:1003008756
Name:EYE 20 OPTICAL INC
Entity Type:Organization
Organization Name:EYE 20 OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SEILER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-367-5116
Mailing Address - Street 1:155 SE LOOP 338
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-9752
Mailing Address - Country:US
Mailing Address - Phone:432-367-5116
Mailing Address - Fax:432-367-0129
Practice Address - Street 1:155 SE LOOP 338
Practice Address - Street 2:SUITE 300
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-9703
Practice Address - Country:US
Practice Address - Phone:432-367-5116
Practice Address - Fax:432-367-0129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0438430001Medicare NSC