Provider Demographics
NPI:1053858241
Name:EYESIGHT HEALTHCARE, PLLC
Entity Type:Organization
Organization Name:EYESIGHT HEALTHCARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:GATES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:361-985-9000
Mailing Address - Street 1:PO BOX 3704
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78463-3704
Mailing Address - Country:US
Mailing Address - Phone:361-985-0478
Mailing Address - Fax:361-985-0966
Practice Address - Street 1:4242 SOUTH ALAMEDA
Practice Address - Street 2:SUITE #18
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-4147
Practice Address - Country:US
Practice Address - Phone:361-985-9000
Practice Address - Fax:361-985-9002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-25
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8082TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty