Provider Demographics
NPI:1407818776
Name:EYE CARE SPECIALTIES, INC.
Entity Type:Organization
Organization Name:EYE CARE SPECIALTIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/ VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMMLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:501-922-5778
Mailing Address - Street 1:101 PLAZA CARMONA PL
Mailing Address - Street 2:SUITE C
Mailing Address - City:HOT SPRINGS VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71909-3000
Mailing Address - Country:US
Mailing Address - Phone:501-922-5778
Mailing Address - Fax:501-922-6659
Practice Address - Street 1:101 PLAZA CARMONA PL
Practice Address - Street 2:SUITE C
Practice Address - City:HOT SPRINGS VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71909-3000
Practice Address - Country:US
Practice Address - Phone:501-922-5778
Practice Address - Fax:501-922-6659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR 2436152W00000X
ARAR 2435152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5B824OtherBLUE CROSS BLUE SHIELD
AR5B824OtherBLUE CROSS BLUE SHIELD
AR51267Medicare UPIN
AR5B824Medicare PIN
AR51441Medicare UPIN