Provider Demographics
NPI:1518371723
Name:DR. ALAN R. TILSON, PC
Entity Type:Organization
Organization Name:DR. ALAN R. TILSON, PC
Other - Org Name:TILSON EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:TILSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-258-2020
Mailing Address - Street 1:4070 N BELT LINE RD
Mailing Address - Street 2:168
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-5028
Mailing Address - Country:US
Mailing Address - Phone:972-258-2020
Mailing Address - Fax:
Practice Address - Street 1:4070 N BELT LINE RD
Practice Address - Street 2:168
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-5028
Practice Address - Country:US
Practice Address - Phone:972-258-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3102T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty