Provider Demographics
NPI:1437575461
Name:AMEDCO TEXAS LLC
Entity Type:Organization
Organization Name:AMEDCO TEXAS LLC
Other - Org Name:EYEAR ONE HOUR OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERREIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-881-0022
Mailing Address - Street 1:8076 W SAHARA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7930
Mailing Address - Country:US
Mailing Address - Phone:877-881-0022
Mailing Address - Fax:702-974-3537
Practice Address - Street 1:4365 N EXPWY
Practice Address - Street 2:STE. 400
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-4857
Practice Address - Country:US
Practice Address - Phone:956-203-0825
Practice Address - Fax:956-404-0119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty