Provider Demographics
NPI:1184923146
Name:EYECARE ASSOCIATES OF WHEATON LLC
Entity type:Organization
Organization Name:EYECARE ASSOCIATES OF WHEATON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPEJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-286-4249
Mailing Address - Street 1:1060 ROCKVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1404
Mailing Address - Country:US
Mailing Address - Phone:301-294-0883
Mailing Address - Fax:240-453-9394
Practice Address - Street 1:11160 VEIRS MILL RD., G1 INSIDE OF LENSCRAFTERS
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902
Practice Address - Country:US
Practice Address - Phone:301-949-3960
Practice Address - Fax:301-949-2429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty