Provider Demographics
NPI:1336579770
Name:EXCELLENT EYE CARE P.A.
Entity Type:Organization
Organization Name:EXCELLENT EYE CARE P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:QUYNH
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-772-9659
Mailing Address - Street 1:2665 MARKET CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6563
Mailing Address - Country:US
Mailing Address - Phone:972-772-9659
Mailing Address - Fax:972-772-3120
Practice Address - Street 1:2665 MARKET CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6563
Practice Address - Country:US
Practice Address - Phone:972-772-9659
Practice Address - Fax:972-772-3120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-21
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6813T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty