Provider Demographics
NPI:1295863454
Name:I ADVANTAGE EYECARE, PA
Entity Type:Organization
Organization Name:I ADVANTAGE EYECARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-788-2020
Mailing Address - Street 1:6509 PRECINCT LINE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-4313
Mailing Address - Country:US
Mailing Address - Phone:817-788-2020
Mailing Address - Fax:817-788-2023
Practice Address - Street 1:6509 PRECINCT LINE RD
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-4313
Practice Address - Country:US
Practice Address - Phone:817-788-2020
Practice Address - Fax:817-788-2023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDA7538OtherRAILROAD MEDICARE
TX00185SMedicare PIN
TX4262020001Medicare NSC