Provider Demographics
NPI:1851954838
Name:SAN GABRIEL EYE CENTER PLLC
Entity Type:Organization
Organization Name:SAN GABRIEL EYE CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:MCCAIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-863-2078
Mailing Address - Street 1:1401 WILLIAMS DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-4115
Mailing Address - Country:US
Mailing Address - Phone:512-863-2078
Mailing Address - Fax:512-869-2077
Practice Address - Street 1:1401 WILLIAMS DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-4115
Practice Address - Country:US
Practice Address - Phone:512-863-2078
Practice Address - Fax:512-869-2077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-16
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty