Provider Demographics
NPI:1114468089
Name:T&T EYECARE, LLC
Entity Type:Organization
Organization Name:T&T EYECARE, LLC
Other - Org Name:SPECS APPEAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MINH
Authorized Official - Middle Name:CONG
Authorized Official - Last Name:TA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-331-3926
Mailing Address - Street 1:2570 BLACKMON DR STE 350
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-6197
Mailing Address - Country:US
Mailing Address - Phone:678-846-2000
Mailing Address - Fax:678-212-5622
Practice Address - Street 1:2570 BLACKMON DR.
Practice Address - Street 2:SUITE 350
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033
Practice Address - Country:US
Practice Address - Phone:678-846-2000
Practice Address - Fax:678-212-5622
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:T&T EYES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-13
Last Update Date:2022-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002034152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty