Provider Demographics
NPI:1821323114
Name:JOE L. BUNCH, O.D.
Entity Type:Organization
Organization Name:JOE L. BUNCH, O.D.
Other - Org Name:DR. JOE L BUNCH
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BUNCH
Authorized Official - Suffix:
Authorized Official - Credentials:OPTOMETRIST
Authorized Official - Phone:972-422-2020
Mailing Address - Street 1:3200 14TH ST
Mailing Address - Street 2:#400
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-4423
Mailing Address - Country:US
Mailing Address - Phone:972-422-2020
Mailing Address - Fax:
Practice Address - Street 1:3200 14TH ST
Practice Address - Street 2:#400
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-4423
Practice Address - Country:US
Practice Address - Phone:972-422-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU12063Medicare UPIN
TX00E12NMedicare PIN