Provider Demographics
NPI:1265218788
Name:ENDEAVOR EYE CENTER, PLLC
Entity type:Organization
Organization Name:ENDEAVOR EYE CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:KEHJYE
Authorized Official - Last Name:CHUANG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:805-404-2269
Mailing Address - Street 1:2514 N ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-5328
Mailing Address - Country:US
Mailing Address - Phone:253-759-5679
Mailing Address - Fax:253-759-0785
Practice Address - Street 1:2514 N ADAMS ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-5328
Practice Address - Country:US
Practice Address - Phone:253-759-5679
Practice Address - Fax:253-759-0785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-01
Last Update Date:2023-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty