Provider Demographics
NPI:1356483622
Name:AREA EYE CENTER PA
Entity Type:Organization
Organization Name:AREA EYE CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:PULPAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:806-435-5406
Mailing Address - Street 1:2309 S CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:PERRYTON
Mailing Address - State:TX
Mailing Address - Zip Code:79070-5901
Mailing Address - Country:US
Mailing Address - Phone:806-435-5406
Mailing Address - Fax:806-435-5407
Practice Address - Street 1:2309 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:PERRYTON
Practice Address - State:TX
Practice Address - Zip Code:79070-5901
Practice Address - Country:US
Practice Address - Phone:806-435-5406
Practice Address - Fax:806-435-5407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180402301TMedicaid
TX0087FAOtherBLUECROSSBLUESHIELD
TX0087FAOtherBLUECROSSBLUESHIELD