Provider Demographics
NPI:1700010592
Name:EYE CARE VISION CENTER II INC ERKERS KIRKWOOD
Entity Type:Organization
Organization Name:EYE CARE VISION CENTER II INC ERKERS KIRKWOOD
Other - Org Name:EYECARE WASHINGTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:M
Authorized Official - Last Name:GUBANY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:636-239-2020
Mailing Address - Street 1:1090 WASHINGTON SQUARE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090
Mailing Address - Country:US
Mailing Address - Phone:636-239-2020
Mailing Address - Fax:636-239-5766
Practice Address - Street 1:1090 WASHINGTON SQ
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-5302
Practice Address - Country:US
Practice Address - Phone:636-239-2020
Practice Address - Fax:636-239-5766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-07
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO2593152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty