Provider Demographics
NPI:1205964335
Name:EYECARE ASSOCIATES, INC.
Entity type:Organization
Organization Name:EYECARE ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WACHTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-200-4393
Mailing Address - Street 1:PO BOX 207243
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-7255
Mailing Address - Country:US
Mailing Address - Phone:636-200-4393
Mailing Address - Fax:636-527-0766
Practice Address - Street 1:7 12TH AVE NW
Practice Address - Street 2:
Practice Address - City:ARAB
Practice Address - State:AL
Practice Address - Zip Code:35016-1977
Practice Address - Country:US
Practice Address - Phone:636-200-4393
Practice Address - Fax:256-586-9790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000059669OtherMEDICARE
AL528800620Medicaid
AL630731355OtherPRINCIPAL FINANCIAL GROUP
AL630731355OtherAETNA
AL051500371OtherMEDICARE
AL630731355OtherHUMANA
AL630731355OtherADVANTRA
AL1205964335OtherTRICARE
AL630731355OtherGEHA
AL051059669OtherBCBS
AL051500371OtherBCBS
AL630731355OtherUNITED HEALTH CARE
AL630731355OtherFIRST HEALTH LIFE AND HEA
ALI405Medicare PIN
AL630731355OtherPRINCIPAL FINANCIAL GROUP
ALU58309Medicare UPIN
AL0774960001Medicare NSC
AL630731355OtherFIRST HEALTH LIFE AND HEA
AL051500371OtherBCBS
AL1841290152Medicare PIN
ALDA9059Medicare PIN