Provider Demographics
NPI:1720252331
Name:SENIOR SIGHT, INC
Entity Type:Organization
Organization Name:SENIOR SIGHT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:DEGENAER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-547-4200
Mailing Address - Street 1:5001 MCKINNEY RANCH PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8601
Mailing Address - Country:US
Mailing Address - Phone:972-547-4200
Mailing Address - Fax:972-547-4202
Practice Address - Street 1:5001 MCKINNEY RANCH PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-8601
Practice Address - Country:US
Practice Address - Phone:972-547-4200
Practice Address - Fax:972-547-4202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4630T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty