Provider Demographics
NPI:1467502443
Name:EYE HEALTH ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:EYE HEALTH ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-481-3231
Mailing Address - Street 1:338 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-5319
Mailing Address - Country:US
Mailing Address - Phone:817-481-2411
Mailing Address - Fax:817-481-0203
Practice Address - Street 1:338 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-5319
Practice Address - Country:US
Practice Address - Phone:817-481-2411
Practice Address - Fax:817-481-0203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1902TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1902TGOtherSTATE LICENSE
TX80642QOtherBLUE CROSS BLUE SHIELD
TX1902TGOtherSTATE LICENSE
TX1902TGOtherSTATE LICENSE
TX0A3850Medicare PIN