Provider Demographics
NPI:1821091943
Name:CHEYNE EYE CENTER P.A.
Entity Type:Organization
Organization Name:CHEYNE EYE CENTER P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:CHEYNE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-573-7153
Mailing Address - Street 1:4000 E US HIGHWAY 377
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76049-7432
Mailing Address - Country:US
Mailing Address - Phone:817-573-7153
Mailing Address - Fax:817-573-5640
Practice Address - Street 1:4000 E US HIGHWAY 377
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76049-7432
Practice Address - Country:US
Practice Address - Phone:817-573-7153
Practice Address - Fax:817-573-5640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5017230001332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00795VMedicare PIN
TX5017230001Medicare NSC