East Texas Vision Center

LBN: Complete Family Eyecare
East Texas Vision Center is an health care organization with primary practice located at 510 Ssw Loop 323 , Tyler TX 75702. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Complete Family Eyecare can be contacted via phone (903) 593-2109, or through Mcgough, John Robert via phone (903) 593-2109.

Contact Information

Primary practice address
510 Ssw Loop 323 Tyler TX 75702
Phone: (903) 593-2109
Fax: (903) 593-4799
Website:
Map and Directions
Authorized official contact:
Name: Mcgough, John Robert Doctor of Optometry (OD)
Phone: (903) 593-2109

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3363TG Texas
Eye and Vision Services Providers / Optometrist 152W00000X LA962 Louisiana

Profile Details

NPI number 1083706352
LBN Legal business name Complete Family Eyecare
DBA Doing business as East Texas Vision Center
Authorized official Mcgough, John Robert Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 28th, 2006
Last updated Jun 23rd, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083706352 NPPES
Texas MEDICAID 019857401

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