Provider Demographics
NPI:1700208857
Name:MEAD EYE CARE PLLC
Entity Type:Organization
Organization Name:MEAD EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:MEAD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-545-7067
Mailing Address - Street 1:1321 N LOOP 1604 E STE 100A
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1438
Mailing Address - Country:US
Mailing Address - Phone:210-545-7067
Mailing Address - Fax:210-545-9629
Practice Address - Street 1:1321 N LOOP 1604 E STE 100A
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1438
Practice Address - Country:US
Practice Address - Phone:210-545-7067
Practice Address - Fax:210-545-9629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-09
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty