Provider Demographics
NPI:1114939444
Name:EYE CARE SERVICES, INC.
Entity Type:Organization
Organization Name:EYE CARE SERVICES, INC.
Other - Org Name:20/20 EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-667-2020
Mailing Address - Street 1:500 NW 20TH ST
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-2441
Mailing Address - Country:US
Mailing Address - Phone:503-667-2020
Mailing Address - Fax:503-667-6386
Practice Address - Street 1:500 NW 20TH ST
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-2441
Practice Address - Country:US
Practice Address - Phone:503-667-2020
Practice Address - Fax:503-667-6386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD06318207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4807090001Medicare NSC
OR115506Medicare ID - Type Unspecified