Provider Demographics
NPI:1164657862
Name:EYE MANAGEMENT LLC
Entity Type:Organization
Organization Name:EYE MANAGEMENT LLC
Other - Org Name:SHARP EYE OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:VIDALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-496-9803
Mailing Address - Street 1:1900 N MAIN AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-3942
Mailing Address - Country:US
Mailing Address - Phone:210-496-9803
Mailing Address - Fax:210-496-0313
Practice Address - Street 1:1900 N MAIN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-3942
Practice Address - Country:US
Practice Address - Phone:210-222-0760
Practice Address - Fax:210-212-6659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-26
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5496900001Medicare NSC