Provider Demographics
NPI:1235830431
Name:CLARA VISTA EYECARE
Entity Type:Organization
Organization Name:CLARA VISTA EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOS
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:MCCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:979-224-2821
Mailing Address - Street 1:1109 ROCK PRAIRIE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-8651
Mailing Address - Country:US
Mailing Address - Phone:936-220-4313
Mailing Address - Fax:936-220-4312
Practice Address - Street 1:19792 HIGHWAY 105 W # 300
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-5632
Practice Address - Country:US
Practice Address - Phone:936-220-4313
Practice Address - Fax:936-220-4312
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JMC WORLDWIDE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty