Provider Demographics
NPI:1265106280
Name:SAGINAW FAMILY EYECARE, PLLC
Entity type:Organization
Organization Name:SAGINAW FAMILY EYECARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANJONETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLVIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-701-8775
Mailing Address - Street 1:9816 N BEACH ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6184
Mailing Address - Country:US
Mailing Address - Phone:817-741-2020
Mailing Address - Fax:
Practice Address - Street 1:616 E BAILEY BOSWELL RD STE 200
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:TX
Practice Address - Zip Code:76131-3575
Practice Address - Country:US
Practice Address - Phone:817-741-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty