Provider Demographics
NPI:1497907372
Name:ALEXANDER OPTOMETRIC CLINIC, P.A.
Entity Type:Organization
Organization Name:ALEXANDER OPTOMETRIC CLINIC, P.A.
Other - Org Name:EYE CARE SPECIALITIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:828-437-2950
Mailing Address - Street 1:149 W PARKER RD STE B
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-4673
Mailing Address - Country:US
Mailing Address - Phone:828-437-2950
Mailing Address - Fax:828-433-8463
Practice Address - Street 1:149 W PARKER RD STE B
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4673
Practice Address - Country:US
Practice Address - Phone:828-437-2950
Practice Address - Fax:828-433-8463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1037152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5916547Medicaid
NC5916547Medicaid
NC0215940001Medicare NSC