Provider Demographics
NPI:1841907615
Name:DEJEAN & KUGLEN EYE ASSOCIATES, LLP
Entity type:Organization
Organization Name:DEJEAN & KUGLEN EYE ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:H
Authorized Official - Last Name:MCCARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-539-4500
Mailing Address - Street 1:400 S LOOP 336 W
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3302
Mailing Address - Country:US
Mailing Address - Phone:936-539-4500
Mailing Address - Fax:936-539-4534
Practice Address - Street 1:129 VISION PARK BLVD STE 110
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3024
Practice Address - Country:US
Practice Address - Phone:936-539-4500
Practice Address - Fax:936-539-4534
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEJEAN & KUGLEN EYE ASSOCIATES, LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies