Provider Demographics
NPI:1003052622
Name:BRIAN GUICE OPTOMETRY, PLLC
Entity Type:Organization
Organization Name:BRIAN GUICE OPTOMETRY, PLLC
Other - Org Name:KAVANAUGH EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:W
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:GUICE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:501-614-9900
Mailing Address - Street 1:5600 KAVANAUGH BLVD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-4424
Mailing Address - Country:US
Mailing Address - Phone:501-614-9900
Mailing Address - Fax:
Practice Address - Street 1:5600 KAVANAUGH BLVD
Practice Address - Street 2:SUITE 8
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-4424
Practice Address - Country:US
Practice Address - Phone:501-614-9900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-02
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR2610152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty