Provider Demographics
NPI:1619181435
Name:FLEMING EYE CARE PA
Entity Type:Organization
Organization Name:FLEMING EYE CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-379-9391
Mailing Address - Street 1:1255 ASHBY ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:73155-0255
Mailing Address - Country:US
Mailing Address - Phone:830-379-9391
Mailing Address - Fax:830-372-1531
Practice Address - Street 1:1255 ASHBY ST
Practice Address - Street 2:SUITE A
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:73155-0255
Practice Address - Country:US
Practice Address - Phone:830-379-9391
Practice Address - Fax:830-372-1531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD8215156FX1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB95651Medicare UPIN
TX00N96XMedicare ID - Type Unspecified