Provider Demographics
NPI:1700946480
Name:EYE CARE CENTERS PLLC
Entity Type:Organization
Organization Name:EYE CARE CENTERS PLLC
Other - Org Name:TENNESSEE EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SILVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:865-882-7470
Mailing Address - Street 1:1798 ROANE STATE HWY
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-8305
Mailing Address - Country:US
Mailing Address - Phone:865-882-7470
Mailing Address - Fax:865-882-8933
Practice Address - Street 1:1798 ROANE STATE HWY
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-8305
Practice Address - Country:US
Practice Address - Phone:865-882-7470
Practice Address - Fax:865-882-2738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4102956OtherBLUECROSS
TN4159390OtherBLUECROSS
TNCF9659OtherRAILROAD MEDICARE
TN4187884OtherBLUECROSS
TN4037769OtherBLUECROSS
TN3132106OtherBLUECROSS
TN4060523OtherBLUECROSS
TN4060532OtherBLUECROSS
TN4070743OtherBLUECROSS
TN3130776OtherBLUECROSS
TN4037769OtherBLUECROSS
TN4060532OtherBLUECROSS