Provider Demographics
NPI:1548611601
Name:CLEAR EYE ASSOCIATES AND OPTICAL PC
Entity Type:Organization
Organization Name:CLEAR EYE ASSOCIATES AND OPTICAL PC
Other - Org Name:CLEAR EYE ASSOCIATES AND OPTICAL PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:713-591-7918
Mailing Address - Street 1:5912 CONVAIR DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-1185
Mailing Address - Country:US
Mailing Address - Phone:817-880-7917
Mailing Address - Fax:817-880-7918
Practice Address - Street 1:5912 CONVAIR DR
Practice Address - Street 2:SUITE 208
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-1185
Practice Address - Country:US
Practice Address - Phone:817-880-7917
Practice Address - Fax:817-880-7918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-29
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7091TG152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty