Provider Demographics
NPI:1619005980
Name:DRS. THOMAS, HOUSE & ASSOCIATES, OPTOMETRISTS, PLLC
Entity Type:Organization
Organization Name:DRS. THOMAS, HOUSE & ASSOCIATES, OPTOMETRISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:704-841-3937
Mailing Address - Street 1:7745 BALLANTYNE COMMONS PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2442
Mailing Address - Country:US
Mailing Address - Phone:704-841-3937
Mailing Address - Fax:704-841-3964
Practice Address - Street 1:7745 BALLANTYNE COMMONS PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2442
Practice Address - Country:US
Practice Address - Phone:704-841-3937
Practice Address - Fax:704-841-3964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC013F5OtherBCBSNC
NC28916OtherCOMMUNITY EYE CARE
NC05415OtherSPECTERA
NC28916OtherCOMMUNITY EYE CARE