Provider Demographics
NPI:1164575445
Name:PERSPECTIVE EYE CARE, PLLC
Entity Type:Organization
Organization Name:PERSPECTIVE EYE CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:CORONADO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-396-0006
Mailing Address - Street 1:1110 NORTH GREENVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002
Mailing Address - Country:US
Mailing Address - Phone:972-396-0006
Mailing Address - Fax:972-396-0004
Practice Address - Street 1:1110 NORTH GREENVILLE AVE
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002
Practice Address - Country:US
Practice Address - Phone:972-396-0006
Practice Address - Fax:972-396-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX04789TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDG1313OtherMEDICARE RAILROAD PTAN
TXDG1313OtherMEDICARE RAILROAD PTAN