Provider Demographics
NPI:1083220255
Name:CLR EYECARE PLLC
Entity Type:Organization
Organization Name:CLR EYECARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:DESMOND
Authorized Official - Last Name:BEAMON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:901-922-8945
Mailing Address - Street 1:5255 ELVIS PRESLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-8233
Mailing Address - Country:US
Mailing Address - Phone:901-922-8945
Mailing Address - Fax:901-346-2574
Practice Address - Street 1:5255 ELVIS PRESLEY BLVD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-8233
Practice Address - Country:US
Practice Address - Phone:901-258-6945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-22
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty