Provider Demographics
NPI:1609950013
Name:CARROLLTON VISION ASSOCIATES, L.L.P.
Entity Type:Organization
Organization Name:CARROLLTON VISION ASSOCIATES, L.L.P.
Other - Org Name:FIRST EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THERAPUETIC OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:B
Authorized Official - Last Name:STILES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-416-1270
Mailing Address - Street 1:2810 E TRINITY MILLS RD
Mailing Address - Street 2:SUITE 173
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-2351
Mailing Address - Country:US
Mailing Address - Phone:972-416-1270
Mailing Address - Fax:972-416-4839
Practice Address - Street 1:2810 E TRINITY MILLS RD
Practice Address - Street 2:SUITE 173
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-2351
Practice Address - Country:US
Practice Address - Phone:972-416-1270
Practice Address - Fax:972-416-4839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX410035592OtherRAILROAD MEDICARE PTAN
TX4358570001Medicare NSC
TX410035592OtherRAILROAD MEDICARE PTAN