1538182944 NPI number — EYE SEE OPTICAL

Table of content: (NPI 1538182944)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538182944 NPI number — EYE SEE OPTICAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EYE SEE OPTICAL
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:
1538182944
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5268 NICHOLSON LN STE D
Provider Second Line Business Mailing Address:
WHITE FLINT PLAZA
Provider Business Mailing Address City Name:
KENSINGTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20895-1010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-881-6232
Provider Business Mailing Address Fax Number:
301-881-6234

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5268 NICHOLSON LN STE D
Provider Second Line Business Practice Location Address:
WHITE FLINT PLAZA
Provider Business Practice Location Address City Name:
KENSINGTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20895-1010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-881-6232
Provider Business Practice Location Address Fax Number:
301-881-6234
Provider Enumeration Date:
07/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CRAWFORD
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
OPTICIAN
Authorized Official Telephone Number:
301-881-6232

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  15215533 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 52-1777649 . This is a "UNITED/DR. PAUL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 923004-024743 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64120201 . This is a "BCBS/EYE SEE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 213335 . This is a "NVA/EYE SEE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 33138 . This is a "AVESIS/ DR. PAUL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 52-1777649 . This is a "SUPERIOR VISION/DR. PAUL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: OP0787 . This is a "EYE MED/ EYE SEE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 50371 . This is a "DAVIS VISION/EYE SEE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 913150-024743 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: OP0848 . This is a "EYE MED/ MIKE CRAWFORD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 50370 . This is a "DAVIS VISION/DR. PAUL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 118585 . This is a "EYE MED/DR. PAUL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 33139 . This is a "AVESIS/EYE SEE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 25667 . This is a "SPECTERA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 4239296 . This is a "AETNA/DR. PAUL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 52-1777649 . This is a "EYE BENEFITS/ DR. PAUL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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