Provider Demographics
NPI:1124195516
Name:ARLINGTON EYECARE ASSOCIATES LLC
Entity Type:Organization
Organization Name:ARLINGTON EYECARE ASSOCIATES LLC
Other - Org Name:PROFESSIONAL EYECARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:CLEVELAND
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:817-496-6022
Mailing Address - Street 1:3703 GREEN OAKS BLVD W
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016
Mailing Address - Country:US
Mailing Address - Phone:817-496-6022
Mailing Address - Fax:817-496-8911
Practice Address - Street 1:3703 W GREEN OAKS BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-3328
Practice Address - Country:US
Practice Address - Phone:817-496-6022
Practice Address - Fax:817-496-8911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDP3176OtherMEDICARE RAILROAD
TXDP3176OtherMEDICARE RAILROAD
TX6228560001Medicare NSC