Provider Demographics
NPI:1407985369
Name:J. CARL NORRIS, OD PC
Entity Type:Organization
Organization Name:J. CARL NORRIS, OD PC
Other - Org Name:MINEOLA EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:HAWARI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:903-569-5432
Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:TX
Mailing Address - Zip Code:75773-0547
Mailing Address - Country:US
Mailing Address - Phone:903-569-5432
Mailing Address - Fax:903-569-2994
Practice Address - Street 1:1238 N PACIFIC ST
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:TX
Practice Address - Zip Code:75773-1002
Practice Address - Country:US
Practice Address - Phone:903-569-5432
Practice Address - Fax:903-569-2994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4091TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00D53COtherBLUE CROSS BLUE SHIELD
TXCG7745OtherRAILROAD MEDICARE
TXCG7745OtherRAILROAD MEDICARE
TX0242130001Medicare NSC