Provider Demographics
NPI:1750078325
Name:EAGLE EYE CARE, PLLC
Entity type:Organization
Organization Name:EAGLE EYE CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:BAILEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-771-0241
Mailing Address - Street 1:325 SEXTON LN
Mailing Address - Street 2:
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76126-3116
Mailing Address - Country:US
Mailing Address - Phone:817-771-0241
Mailing Address - Fax:
Practice Address - Street 1:1120 FM 1189 STE 106
Practice Address - Street 2:
Practice Address - City:MILLSAP
Practice Address - State:TX
Practice Address - Zip Code:76066-3546
Practice Address - Country:US
Practice Address - Phone:817-771-0241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty