Provider Demographics
NPI:1073827051
Name:LINDA M. MCCLAIN, OD PC
Entity Type:Organization
Organization Name:LINDA M. MCCLAIN, OD PC
Other - Org Name:ON SIGHT VISION CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-605-8500
Mailing Address - Street 1:101 ARANSAS CV
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78633-4836
Mailing Address - Country:US
Mailing Address - Phone:512-605-8500
Mailing Address - Fax:512-591-7651
Practice Address - Street 1:101 ARANSAS CV
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78633-4836
Practice Address - Country:US
Practice Address - Phone:512-605-8500
Practice Address - Fax:512-591-7651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-02
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB106456OtherMEDICARE PTAN