Provider Demographics
NPI:1134531320
Name:SINGLETON EYECARE CENTER
Entity type:Organization
Organization Name:SINGLETON EYECARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLYDE
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGLETON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-263-2020
Mailing Address - Street 1:7451 MCCART AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-7296
Mailing Address - Country:US
Mailing Address - Phone:817-263-2020
Mailing Address - Fax:
Practice Address - Street 1:7451 MCCART AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-7296
Practice Address - Country:US
Practice Address - Phone:817-263-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6851-TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1764246-02Medicaid
TXU95352Medicare UPIN
TX1764246-02Medicaid
TXTXB127756Medicare Oscar/Certification