Provider Demographics
NPI:1023008687
Name:LE OPTI TECH INC
Entity Type:Organization
Organization Name:LE OPTI TECH INC
Other - Org Name:IRVING EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:MILES
Authorized Official - Last Name:KARDATZKE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-254-0033
Mailing Address - Street 1:PO BOX 153328
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75015-3328
Mailing Address - Country:US
Mailing Address - Phone:972-254-0033
Mailing Address - Fax:972-254-0055
Practice Address - Street 1:708 N MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-7355
Practice Address - Country:US
Practice Address - Phone:972-254-0033
Practice Address - Fax:972-254-0055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y23809Medicare UPIN
8C9702Medicare ID - Type Unspecified