Provider Demographics
NPI:1821828666
Name:PANTHER CITY EYE CARE PLLC
Entity type:Organization
Organization Name:PANTHER CITY EYE CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ERVIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:682-747-6319
Mailing Address - Street 1:2902 RACE ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76111-4104
Mailing Address - Country:US
Mailing Address - Phone:682-747-6319
Mailing Address - Fax:817-225-3467
Practice Address - Street 1:2902 RACE ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76111-4104
Practice Address - Country:US
Practice Address - Phone:682-747-6319
Practice Address - Fax:817-238-3511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty