Provider Demographics
NPI:1982674578
Name:FAMILY EYE CARE OF OSCEOLA PC
Entity Type:Organization
Organization Name:FAMILY EYE CARE OF OSCEOLA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:641-342-4356
Mailing Address - Street 1:PO BOX 423
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50213-0423
Mailing Address - Country:US
Mailing Address - Phone:641-342-4356
Mailing Address - Fax:641-342-4265
Practice Address - Street 1:110 S FILLMORE ST
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IA
Practice Address - Zip Code:50213-1201
Practice Address - Country:US
Practice Address - Phone:641-342-4356
Practice Address - Fax:641-342-4265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA3792283Medicaid
IA=========OtherVSP
IA=========OtherMEDICARE COMPLETE
IA=========OtherADVANTRA
IA=========OtherPYRAMID
IA=========OtherHUMANA
IA=========OtherSECURE HORIZONS
IA1200760001Medicare NSC
IA=========OtherMEDICARE COMPLETE
IA=========OtherHUMANA