Provider Demographics
NPI:1558533299
Name:BRIGHT SIGHT EYECARE INC
Entity Type:Organization
Organization Name:BRIGHT SIGHT EYECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BRYON
Authorized Official - Last Name:PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:803-397-6605
Mailing Address - Street 1:340 SIDDINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-9722
Mailing Address - Country:US
Mailing Address - Phone:803-356-1414
Mailing Address - Fax:803-356-0515
Practice Address - Street 1:1780 S LAKE DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-8102
Practice Address - Country:US
Practice Address - Phone:803-356-1414
Practice Address - Fax:803-356-0515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1444152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCD14447Medicaid
SCD14447Medicaid