Provider Demographics
NPI:1144348822
Name:PRECISION EYE CARE, PLLC
Entity type:Organization
Organization Name:PRECISION EYE CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JANUSKEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:979-985-5305
Mailing Address - Street 1:3975 STATE HIGHWAY 6 S
Mailing Address - Street 2:SUITE 900
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-5895
Mailing Address - Country:US
Mailing Address - Phone:979-985-5305
Mailing Address - Fax:979-764-4312
Practice Address - Street 1:3975 STATE HWY 6
Practice Address - Street 2:SUITE 900
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845
Practice Address - Country:US
Practice Address - Phone:979-985-5305
Practice Address - Fax:713-995-0548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX06893TG174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX IDENTIFICATION NUMBER
TX00Y068Medicare PIN