Provider Demographics
NPI:1619351350
Name:AGGIELAND EYECARE
Entity Type:Organization
Organization Name:AGGIELAND EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/ PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:S
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:979-696-7343
Mailing Address - Street 1:505 UNIVERSITY DR E STE 101
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-1790
Mailing Address - Country:US
Mailing Address - Phone:979-696-7343
Mailing Address - Fax:979-696-8251
Practice Address - Street 1:505 UNIVERSITY DR E STE 101
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-1790
Practice Address - Country:US
Practice Address - Phone:979-696-7343
Practice Address - Fax:979-696-8251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3467152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty