Provider Demographics
NPI:1669505129
Name:BUTHOD EYE CARE, PA
Entity Type:Organization
Organization Name:BUTHOD EYE CARE, PA
Other - Org Name:CARROLLTON EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:P
Authorized Official - Last Name:BUTHOD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-395-8434
Mailing Address - Street 1:3720 N JOSEY LN
Mailing Address - Street 2:SUITE 114
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-2481
Mailing Address - Country:US
Mailing Address - Phone:972-395-8434
Mailing Address - Fax:975-395-8435
Practice Address - Street 1:3720 N JOSEY LN
Practice Address - Street 2:SUITE 114
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2481
Practice Address - Country:US
Practice Address - Phone:972-395-8434
Practice Address - Fax:975-395-8435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Z620Medicare PIN