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Contact Information

2020 EYEDR
1251 E SOUTHLAKE BLVD
SUITE 331
SOUTHLAKE, TX76092-6478
 Phone: 630-452-6290
 Fax: 888-619-2009
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for 2020 EYEDR

NPI Number 1942754700
LBN Legal business name 2020 EYEDR
Authorized official MANOJ ABRAHAM - (OPTOMETRIST)
Entity Organization
Organization subpart 1 No
Enumeration date 08/10/2016
Last updated 08/10/2016 - About 10 years ago
Identifiers
TX License # 8563
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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