Provider Demographics
NPI:1073639191
Name:PARIS EYE PHYSICIANS & SURGEONS PA
Entity Type:Organization
Organization Name:PARIS EYE PHYSICIANS & SURGEONS PA
Other - Org Name:NONE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:M
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-785-4166
Mailing Address - Street 1:1235 NE LOOP 286
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-2226
Mailing Address - Country:US
Mailing Address - Phone:903-785-4166
Mailing Address - Fax:903-785-4172
Practice Address - Street 1:1235 NE LOOP 286
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-2226
Practice Address - Country:US
Practice Address - Phone:903-785-4166
Practice Address - Fax:903-785-4172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5664174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACS7990OtherRAILROAD MEDICARE
TX094766501Medicaid
TX0167930001Medicare NSC
GACS7990OtherRAILROAD MEDICARE