Provider Demographics
NPI:1598754111
Name:JBK EYE CARE LLP
Entity Type:Organization
Organization Name:JBK EYE CARE LLP
Other - Org Name:ADVANCED EYE CARE CANYON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:L
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:806-655-7748
Mailing Address - Street 1:1801 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-3853
Mailing Address - Country:US
Mailing Address - Phone:806-655-7748
Mailing Address - Fax:806-655-2871
Practice Address - Street 1:1801 4TH AVE
Practice Address - Street 2:
Practice Address - City:CANYON
Practice Address - State:TX
Practice Address - Zip Code:79015-3853
Practice Address - Country:US
Practice Address - Phone:806-655-7748
Practice Address - Fax:806-655-2871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-17
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX02644TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6050390001OtherMEDICARE DME
TXDF9367Medicare PIN
TX00X769Medicare PIN
TX6050390001Medicare PIN
TX6050390001OtherMEDICARE DME