Provider Demographics
NPI:1376789370
Name:QUALITY EYE CARE LLC
Entity Type:Organization
Organization Name:QUALITY EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATAYA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:515-370-2969
Mailing Address - Street 1:4105 SW BLUEGRASS DR
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-8280
Mailing Address - Country:US
Mailing Address - Phone:515-370-2969
Mailing Address - Fax:
Practice Address - Street 1:4105 SW BLUEGRASS DR
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-8280
Practice Address - Country:US
Practice Address - Phone:515-370-2969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-21
Last Update Date:2008-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002401152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty