Provider Demographics
NPI:1013169044
Name:MCANDREW'S EYE CLINIC
Entity Type:Organization
Organization Name:MCANDREW'S EYE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCANDREW
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:432-699-4827
Mailing Address - Street 1:700 N MARIENFELD ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-3360
Mailing Address - Country:US
Mailing Address - Phone:432-699-4827
Mailing Address - Fax:
Practice Address - Street 1:700 N MARIENFELD ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-3360
Practice Address - Country:US
Practice Address - Phone:432-699-4827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5302TG OPTOMETRY261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX019468001Medicaid
TXU65085Medicare UPIN