Provider Demographics
NPI:1831611706
Name:FORESIGHT EYE CARE PLLC
Entity type:Organization
Organization Name:FORESIGHT EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JARREN
Authorized Official - Middle Name:B
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:806-784-1465
Mailing Address - Street 1:3410 98TH ST STE 4-142
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-3847
Mailing Address - Country:US
Mailing Address - Phone:806-784-1465
Mailing Address - Fax:806-784-1466
Practice Address - Street 1:6020 34TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-3102
Practice Address - Country:US
Practice Address - Phone:806-784-1465
Practice Address - Fax:806-784-1466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-12
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7292152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty