Provider Demographics
NPI:1508179458
Name:VEATCH EYE CARE, P.C.
Entity Type:Organization
Organization Name:VEATCH EYE CARE, P.C.
Other - Org Name:BLINK VISION BY VEATCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:VEATCH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:319-665-2727
Mailing Address - Street 1:2441 CORAL CT
Mailing Address - Street 2:SUITE #5
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-2872
Mailing Address - Country:US
Mailing Address - Phone:319-665-2727
Mailing Address - Fax:
Practice Address - Street 1:2441 CORAL CT
Practice Address - Street 2:SUITE #5
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2872
Practice Address - Country:US
Practice Address - Phone:319-665-2727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-21
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02335152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP10I15909Medicare PIN
IAV06314Medicare UPIN