Provider Demographics
NPI:1639436108
Name:EYE-DO OPTICAL, INC.
Entity Type:Organization
Organization Name:EYE-DO OPTICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:E
Authorized Official - Last Name:GUNDERSHEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:903-868-1135
Mailing Address - Street 1:600 E TAYLOR ST STE 210
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-2844
Mailing Address - Country:US
Mailing Address - Phone:903-868-1135
Mailing Address - Fax:903-891-0181
Practice Address - Street 1:600 E TAYLOR ST STE 210
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2844
Practice Address - Country:US
Practice Address - Phone:903-868-1135
Practice Address - Fax:903-891-0181
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JEROME E GUNDERSHEIMER, OD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-20
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3473TG152W00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0933483-01Medicaid
TXT90646Medicare UPIN
TX00E65BMedicare PIN