Provider Demographics
NPI:1003549387
Name:NATIONAL EYECARE ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:NATIONAL EYECARE ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOUKLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:678-360-4073
Mailing Address - Street 1:4183 MACKENZIE CT
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-4663
Mailing Address - Country:US
Mailing Address - Phone:678-360-4073
Mailing Address - Fax:
Practice Address - Street 1:4183 MACKENZIE CT
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-4663
Practice Address - Country:US
Practice Address - Phone:678-360-4073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty