Provider Demographics
NPI:1437284593
Name:EYECARE ASSOCIATES, INC
Entity Type:Organization
Organization Name:EYECARE ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:CLYDE
Authorized Official - Middle Name:G
Authorized Official - Last Name:ECHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:205-854-6080
Mailing Address - Street 1:PO BOX 207243
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-7243
Mailing Address - Country:US
Mailing Address - Phone:636-200-4393
Mailing Address - Fax:636-527-0766
Practice Address - Street 1:2525 CENTER POINT PKWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35215-2548
Practice Address - Country:US
Practice Address - Phone:636-200-4393
Practice Address - Fax:205-856-2036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS367TA032332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529803870Medicaid
AL1861708745OtherINDIVIDUAL NPI
T69194Medicare UPIN
AL102I411474Medicare PIN
ALU91840Medicare UPIN
AL529803870Medicaid