20/20 Icare Tyler Pllc

NPI Registration Record

Provider / Organization	NPI	Date Certified
20/20 ICARE TYLER PLLC	1073240271	2022-08-07

The organization 20/20 Icare Tyler Pllc is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1073240271. Registration indicates 20/20 Icare Tyler Pllc is a provider of access to ophthalmic care services with a specialization in Eye & Vision Services Providers, Optometrist (Eye and Vision Services Providers, Optometrist) (Optometrist, ) (Vision/Audiology, ) (Optometrist, Eye and Vision Services Providers)

Entity Type	Organization

Provider Organization	20/20 ICARE TYLER PLLC
Practice Office Address	4824 S BROADWAY AVE TYLER, TX US
Practice Office Telephone	9035812020
Mailing Address	5836 SUNNY MEADOW LN GRAND PRAIRIE, TX 750528782 US
Authorized Official	LONG DO, PRESIDENT 8172622145

HPT Codes

Code	Practice	License No State
152W00000X PRIMARY	Access to Ophthalmic Care Eye & Vision Services Providers Optometrist Eye and Vision Services Providers Optometrist Optometrist Vision/Audiology Optometrist Eye and Vision Services Providers
193400000X SING		Group Code

OPI Codes

8143TG

OTHER

TEXAS OPTOMETRY

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