Provider Demographics
NPI:1760625370
Name:CAPLAN EYE CENTER, LLC
Entity Type:Organization
Organization Name:CAPLAN EYE CENTER, LLC
Other - Org Name:ANGELO EYE CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:BLANKENSHIP
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:325-947-2020
Mailing Address - Street 1:3524 KNICKERBOCKER RD
Mailing Address - Street 2:STE C PMB 337
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-7611
Mailing Address - Country:US
Mailing Address - Phone:325-947-2020
Mailing Address - Fax:325-947-2021
Practice Address - Street 1:114 W CONCHO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903
Practice Address - Country:US
Practice Address - Phone:325-947-2020
Practice Address - Fax:325-947-2021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6497TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB103639Medicare PIN