Provider Demographics
NPI:1346740917
Name:CROSS ROADS EYECARE, PLLC
Entity type:Organization
Organization Name:CROSS ROADS EYECARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:HEATH
Authorized Official - Middle Name:A
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:940-488-4228
Mailing Address - Street 1:8800 US HIGHWAY 380 STE 500
Mailing Address - Street 2:
Mailing Address - City:CROSSROADS
Mailing Address - State:TX
Mailing Address - Zip Code:76227-2516
Mailing Address - Country:US
Mailing Address - Phone:940-488-4228
Mailing Address - Fax:940-591-8368
Practice Address - Street 1:8800 US HIGHWAY 380 STE 500
Practice Address - Street 2:
Practice Address - City:CROSSROADS
Practice Address - State:TX
Practice Address - Zip Code:76227-2516
Practice Address - Country:US
Practice Address - Phone:940-488-4228
Practice Address - Fax:940-591-8368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty