Provider Demographics
NPI:1184796831
Name:DIAMOND K EYECARE INC
Entity type:Organization
Organization Name:DIAMOND K EYECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:YAREMA
Authorized Official - Last Name:KLUFAS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-651-3926
Mailing Address - Street 1:6102 FM 3009
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154
Mailing Address - Country:US
Mailing Address - Phone:210-651-3926
Mailing Address - Fax:210-651-7494
Practice Address - Street 1:6102 FM 3009
Practice Address - Street 2:SUITE 100
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154
Practice Address - Country:US
Practice Address - Phone:210-651-3926
Practice Address - Fax:210-651-7494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0062FFOtherBCBS
TX0007196758OtherAETNA
TX175572001Medicaid
TX178891551107OtherHUMANA
TX0062FFOtherBCBS
TX=========0000OtherCIGNA
TX0007196758OtherAETNA
TX175572001Medicaid
TX=========0000OtherCIGNA