Provider Demographics
NPI:1750738407
Name:TWO KINGS EYE CARE PLLC
Entity type:Organization
Organization Name:TWO KINGS EYE CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:J
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-907-1713
Mailing Address - Street 1:12457 TIMBERLAND BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-5210
Mailing Address - Country:US
Mailing Address - Phone:817-741-4177
Mailing Address - Fax:817-741-3444
Practice Address - Street 1:12457 TIMBERLAND BLVD
Practice Address - Street 2:STE 201
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-5210
Practice Address - Country:US
Practice Address - Phone:817-741-4177
Practice Address - Fax:817-741-3444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty