Provider Demographics
NPI:1982250262
Name:EYE CENTERS OF NORTH TEXAS, PLLC
Entity Type:Organization
Organization Name:EYE CENTERS OF NORTH TEXAS, PLLC
Other - Org Name:RETINA OF NORTH TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAI
Authorized Official - Middle Name:HEMANTH
Authorized Official - Last Name:CHAVALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-233-6170
Mailing Address - Street 1:6417 JOYCE WAY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-2316
Mailing Address - Country:US
Mailing Address - Phone:216-849-0437
Mailing Address - Fax:
Practice Address - Street 1:11615 FOREST CENTRAL DR STE 308
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3921
Practice Address - Country:US
Practice Address - Phone:214-233-6170
Practice Address - Fax:214-241-4947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-13
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty