Provider Demographics
NPI:1700247186
Name:EYE C OPTICAL
Entity Type:Organization
Organization Name:EYE C OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:DI PASCUALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-626-5225
Mailing Address - Street 1:2900 PERSHING DR STE A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-2483
Mailing Address - Country:US
Mailing Address - Phone:915-626-5225
Mailing Address - Fax:915-626-5282
Practice Address - Street 1:2900 PERSHING DR STE A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-2483
Practice Address - Country:US
Practice Address - Phone:915-626-5225
Practice Address - Fax:915-626-5282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7917332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier