Provider Demographics
NPI:1245354901
Name:SEITZ EYE CARE, INC
Entity type:Organization
Organization Name:SEITZ EYE CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF INSURANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:TESAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-789-1552
Mailing Address - Street 1:185 N VERNAL AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-2100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:435-789-1551
Practice Address - Street 1:185 N VERNAL AVE STE 3
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-2100
Practice Address - Country:US
Practice Address - Phone:435-789-1552
Practice Address - Fax:435-789-1551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1145979934152W00000X
UT1137489934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT0461410001Medicare NSC