Provider Demographics
NPI:1710131685
Name:DOBSON OPTOMETRIC EYECARE, PA
Entity Type:Organization
Organization Name:DOBSON OPTOMETRIC EYECARE, PA
Other - Org Name:DR. TERENCE M. WARREN, O.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERENCE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:336-386-8526
Mailing Address - Street 1:P.O. BOX 247
Mailing Address - Street 2:DOBSON OPTOMETRIC EYECARE
Mailing Address - City:DOBSON
Mailing Address - State:NC
Mailing Address - Zip Code:27017
Mailing Address - Country:US
Mailing Address - Phone:336-386-8526
Mailing Address - Fax:336-386-8526
Practice Address - Street 1:220 S. MAIN STREET
Practice Address - Street 2:DOBSON OPTOMETRIC EYECARE
Practice Address - City:DOBSON
Practice Address - State:NC
Practice Address - Zip Code:27017
Practice Address - Country:US
Practice Address - Phone:336-386-8526
Practice Address - Fax:336-386-4180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1136152W00000X
NCNC1136152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8909953Medicaid
NC1427016831OtherBCBS
NC1427016831Medicaid
NC1427016831Medicare UPIN
NC1427016831Medicaid
246444AMedicare PIN