Provider Demographics
NPI:1700064540
Name:THE EYE CENTER P A
Entity Type:Organization
Organization Name:THE EYE CENTER P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:J
Authorized Official - Last Name:SANDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-586-7900
Mailing Address - Street 1:3601 4TH ST STOP 7217
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-7217
Mailing Address - Country:US
Mailing Address - Phone:806-743-2020
Mailing Address - Fax:806-743-2471
Practice Address - Street 1:4702 85TH STREET STOP 7217
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-0002
Practice Address - Country:US
Practice Address - Phone:903-216-6902
Practice Address - Fax:806-743-2471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX152W00000X, 207W00000X
207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX194226001Medicaid