Provider Demographics
NPI:1790855898
Name:TEXAS REGIONAL EYE CENTER PLLC
Entity Type:Organization
Organization Name:TEXAS REGIONAL EYE CENTER PLLC
Other - Org Name:TEXAS REGIONAL EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-774-0498
Mailing Address - Street 1:3811 SAGEBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-6107
Mailing Address - Country:US
Mailing Address - Phone:979-774-0498
Mailing Address - Fax:979-774-7673
Practice Address - Street 1:3811 SAGEBRIAR DR
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-6107
Practice Address - Country:US
Practice Address - Phone:979-774-0498
Practice Address - Fax:979-774-7673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX172900601Medicaid