Provider Demographics
NPI:1104221852
Name:TOTAL EYECARE PLLC
Entity Type:Organization
Organization Name:TOTAL EYECARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:701-870-0682
Mailing Address - Street 1:819 MAYFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-8507
Mailing Address - Country:US
Mailing Address - Phone:701-870-0682
Mailing Address - Fax:
Practice Address - Street 1:2821 ROCK ISLAND PL
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-7720
Practice Address - Country:US
Practice Address - Phone:701-222-1724
Practice Address - Fax:701-222-1732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND718152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty