Provider Demographics
NPI:1952619066
Name:BP EYE CARE CENTERS
Entity Type:Organization
Organization Name:BP EYE CARE CENTERS
Other - Org Name:TSO FREDERICKSBURG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BHAVESHKUMAR
Authorized Official - Middle Name:RAMESH
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-791-9560
Mailing Address - Street 1:1021 S STATE HIGHWAY 16
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4472
Mailing Address - Country:US
Mailing Address - Phone:830-992-3286
Mailing Address - Fax:866-473-0040
Practice Address - Street 1:1021 S STATE HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4472
Practice Address - Country:US
Practice Address - Phone:830-992-3286
Practice Address - Fax:866-473-0040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-23
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7124TG152W00000X
TX7139TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty