Provider Demographics
NPI:1073966503
Name:CATARACT AND EYECARE CENTER PROFESSIONAL LLC
Entity Type:Organization
Organization Name:CATARACT AND EYECARE CENTER PROFESSIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AND INSURANCE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-446-9988
Mailing Address - Street 1:10100 RAMSEY WAY
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-1085
Mailing Address - Country:US
Mailing Address - Phone:615-446-1915
Mailing Address - Fax:615-441-9998
Practice Address - Street 1:10100 RAMSEY WAY
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-1085
Practice Address - Country:US
Practice Address - Phone:615-446-1915
Practice Address - Fax:615-441-9998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000036018207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty