Provider Demographics
NPI:1275651887
Name:EYE TO EYE OPTICAL CENTER
Entity Type:Organization
Organization Name:EYE TO EYE OPTICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:901-386-5031
Mailing Address - Street 1:3624 AUSTIN PEAY HWY
Mailing Address - Street 2:SUITE6
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-3776
Mailing Address - Country:US
Mailing Address - Phone:901-386-5031
Mailing Address - Fax:901-386-0338
Practice Address - Street 1:3624 AUSTIN PEAY HWY
Practice Address - Street 2:SUITE6
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-3776
Practice Address - Country:US
Practice Address - Phone:901-386-5031
Practice Address - Fax:901-386-0338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPO 225332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0063093OtherBC BS OF TN