Provider Demographics
NPI:1225217359
Name:DOCTORS EYEWEAR INC.
Entity Type:Organization
Organization Name:DOCTORS EYEWEAR INC.
Other - Org Name:DR SHROPSHIRE AND ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHROPSHIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-387-3937
Mailing Address - Street 1:4948 GULFSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-7632
Mailing Address - Country:US
Mailing Address - Phone:972-387-3937
Mailing Address - Fax:972-387-0606
Practice Address - Street 1:4948 GULFSTREAM DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-7632
Practice Address - Country:US
Practice Address - Phone:972-387-3937
Practice Address - Fax:972-387-0606
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOCTORS EYEWEAR INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-25
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX03391T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112287103Medicaid
TX00B02GMedicare PIN