Provider Demographics
NPI:1013326958
Name:EYEWORKS
Entity type:Organization
Organization Name:EYEWORKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:AYNN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:UPTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:361-993-5882
Mailing Address - Street 1:1504 HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411
Mailing Address - Country:US
Mailing Address - Phone:361-993-5882
Mailing Address - Fax:361-993-4599
Practice Address - Street 1:1504 HOLLY RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411
Practice Address - Country:US
Practice Address - Phone:361-993-5882
Practice Address - Fax:361-993-4599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5299152W00000X
TX3996152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU-13822Medicare UPIN