Provider Demographics
NPI:1558527077
Name:OMNI EYE CARE CENTER PC
Entity Type:Organization
Organization Name:OMNI EYE CARE CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARKAR
Authorized Official - Middle Name:
Authorized Official - Last Name:TAROYAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-985-7888
Mailing Address - Street 1:5926 W PARKER RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6437
Mailing Address - Country:US
Mailing Address - Phone:972-985-7888
Mailing Address - Fax:972-612-1053
Practice Address - Street 1:5926 W PARKER RD
Practice Address - Street 2:SUITE 400
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6437
Practice Address - Country:US
Practice Address - Phone:972-985-7888
Practice Address - Fax:972-612-1053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2643TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00E26KOtherBCBS OF TEXAS
TX00E26KOtherBCBS OF TEXAS
TX356114Medicare PIN