Provider Demographics
NPI:1013970615
Name:SOBER FAMILY EYE CARE PA
Entity Type:Organization
Organization Name:SOBER FAMILY EYE CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:HORVAT
Authorized Official - Last Name:SOBER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:410-682-2888
Mailing Address - Street 1:8841C BELAIR RD
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-2403
Mailing Address - Country:US
Mailing Address - Phone:410-682-2888
Mailing Address - Fax:410-682-9936
Practice Address - Street 1:8841C BELAIR RD
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-2403
Practice Address - Country:US
Practice Address - Phone:410-682-2888
Practice Address - Fax:410-682-9936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD801138900Medicaid
MD801138900Medicaid
T60008Medicare UPIN
MD0322540001Medicare NSC