Provider Demographics
NPI:1689370827
Name:ASSOCIATED VISION CARE, LTD
Entity Type:Organization
Organization Name:ASSOCIATED VISION CARE, LTD
Other - Org Name:LAKEPOINTE VISION CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:BECHERER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:618-581-9266
Mailing Address - Street 1:540 FULLERTON RD
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:IL
Mailing Address - Zip Code:62226-2970
Mailing Address - Country:US
Mailing Address - Phone:618-277-0800
Mailing Address - Fax:
Practice Address - Street 1:1003 E WESLEY DR STE A
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-6142
Practice Address - Country:US
Practice Address - Phone:618-624-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty