Provider Demographics
NPI:1053466821
Name:EYECARE ASSOCIATES, INC
Entity Type:Organization
Organization Name:EYECARE ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARBONI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-878-0125
Mailing Address - Street 1:PO BOX 207243
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-7255
Mailing Address - Country:US
Mailing Address - Phone:636-200-4393
Mailing Address - Fax:636-527-0766
Practice Address - Street 1:7419 HWY 431 N COLLINS PLAZA
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-1194
Practice Address - Country:US
Practice Address - Phone:636-200-4393
Practice Address - Fax:256-878-0939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS453TA283152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1851373385OtherINDIVIDUAL NPI
AL1053466821OtherGROUP NPI
AL529911210Medicaid
AL06834Medicare ID - Type Unspecified
AL1074080021Medicare NSC
AL1851373385OtherINDIVIDUAL NPI
ALT69150Medicare UPIN