1366555633 NPI number — PARENTI-MORRIS EYECARE PLLC

Table of content: (NPI 1366555633)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366555633 NPI number — PARENTI-MORRIS EYECARE PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PARENTI-MORRIS EYECARE PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366555633
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/09/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3710 SOUTHERN HILLS BLVD STE 200
Provider Second Line Business Mailing Address:
PARENTI-MORRIS EYE CARE
Provider Business Mailing Address City Name:
ROGERS
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72758-8093
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
479-636-1960
Provider Business Mailing Address Fax Number:
479-636-8012

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3710 SOUTHERN HILLS BOULEVARD STE 200
Provider Second Line Business Practice Location Address:
PARENTI MORRIS EYE CARE
Provider Business Practice Location Address City Name:
ROGERS
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72758
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-636-1960
Provider Business Practice Location Address Fax Number:
479-636-8012
Provider Enumeration Date:
08/17/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MORRIS
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
OWNER/OPTOMETRIST
Authorized Official Telephone Number:
479-636-1960

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  MORRIS 2491 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 152W00000X , with the licence number: PARENTI 2146 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: BELL 2621 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 140530722 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".