Provider Demographics
NPI:1881241792
Name:RADIANT EYE CARE OPTOMETRIC CORPORATION
Entity type:Organization
Organization Name:RADIANT EYE CARE OPTOMETRIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:479-777-2697
Mailing Address - Street 1:2954 CARLEY PL
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-7420
Mailing Address - Country:US
Mailing Address - Phone:479-531-3056
Mailing Address - Fax:
Practice Address - Street 1:5653 GATEWAY AVE APT D
Practice Address - Street 2:
Practice Address - City:TONTITOWN
Practice Address - State:AR
Practice Address - Zip Code:72762-3275
Practice Address - Country:US
Practice Address - Phone:479-777-2697
Practice Address - Fax:479-763-3212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-25
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty