Provider Demographics
NPI:1366689051
Name:DALLAS EYEWORKS INC
Entity Type:Organization
Organization Name:DALLAS EYEWORKS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRES.
Authorized Official - Prefix:DR
Authorized Official - First Name:CLINT
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-660-9830
Mailing Address - Street 1:9225 GARLAND RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3638
Mailing Address - Country:US
Mailing Address - Phone:214-660-9830
Mailing Address - Fax:
Practice Address - Street 1:9225 GARLAND RD STE 2120
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3638
Practice Address - Country:US
Practice Address - Phone:214-660-9830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3507TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXGROUP # 0031FDOtherBCBS TX
TXT14811Medicare UPIN
TXTXB115505Medicare PIN