Provider Demographics
NPI:1952122392
Name:THOMAS S. BEAL, O.D. LLC
Entity type:Organization
Organization Name:THOMAS S. BEAL, O.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:BEAL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:440-476-3756
Mailing Address - Street 1:36470 CARRIAGE LN
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4175
Mailing Address - Country:US
Mailing Address - Phone:440-476-3756
Mailing Address - Fax:216-378-2684
Practice Address - Street 1:26300 CEDAR RD STE 2300
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-1185
Practice Address - Country:US
Practice Address - Phone:216-378-9128
Practice Address - Fax:216-378-2684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty