Provider Demographics
NPI:1093994436
Name:EYE CONTACTS
Entity Type:Organization
Organization Name:EYE CONTACTS
Other - Org Name:EYE CONTACTS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OPTRICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:FABIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-269-7300
Mailing Address - Street 1:CALLE FLAMBOYANES CC33
Mailing Address - Street 2:RIO HONDO III
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-269-7300
Mailing Address - Fax:
Practice Address - Street 1:CC33 CALLE FLAMBOYANES
Practice Address - Street 2:RIO HONDO III
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-3407
Practice Address - Country:US
Practice Address - Phone:787-269-7300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service