Provider Demographics
NPI:1598339640
Name:BROOKS WOOD EYECARE LLC
Entity Type:Organization
Organization Name:BROOKS WOOD EYECARE LLC
Other - Org Name:ALLEN EYECARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:BROOKS
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:972-727-5717
Mailing Address - Street 1:321 N ALLEN DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-2539
Mailing Address - Country:US
Mailing Address - Phone:972-727-5717
Mailing Address - Fax:972-727-9927
Practice Address - Street 1:321 N ALLEN DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2539
Practice Address - Country:US
Practice Address - Phone:972-727-5717
Practice Address - Fax:972-727-9927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-13
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty