Provider Demographics
NPI:1821019928
Name:RC EYE ASSOCIATES PLLC
Entity Type:Organization
Organization Name:RC EYE ASSOCIATES PLLC
Other - Org Name:RC EYE ASSOCIATES PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICER AND AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:BOYD
Authorized Official - Last Name:BALDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-234-5954
Mailing Address - Street 1:1501 N REDBUD BLVD
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-3226
Mailing Address - Country:US
Mailing Address - Phone:972-548-0771
Mailing Address - Fax:972-562-2300
Practice Address - Street 1:1501 N REDBUD BLVD
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3226
Practice Address - Country:US
Practice Address - Phone:972-548-0771
Practice Address - Fax:972-562-2300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX085765801Medicaid