Provider Demographics
NPI:1558904466
Name:GOLDEN EYE CENTRAL, PLLC
Entity Type:Organization
Organization Name:GOLDEN EYE CENTRAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLY
Authorized Official - Middle Name:KENDALL
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:903-319-1158
Mailing Address - Street 1:4633 NW LOOP # 436
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75633-2205
Mailing Address - Country:US
Mailing Address - Phone:903-631-0166
Mailing Address - Fax:903-690-7258
Practice Address - Street 1:4633 NW LOOP # 436
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:TX
Practice Address - Zip Code:75633-2205
Practice Address - Country:US
Practice Address - Phone:903-631-0166
Practice Address - Fax:903-690-7258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-23
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty