Provider Demographics
NPI:1528056975
Name:GINTER EYECARE CENTER INC.
Entity type:Organization
Organization Name:GINTER EYECARE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEWELL
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:GINTER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:806-798-8820
Mailing Address - Street 1:6010 82ND ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-0822
Mailing Address - Country:US
Mailing Address - Phone:806-798-8820
Mailing Address - Fax:806-798-9754
Practice Address - Street 1:6010 82ND ST STE 100
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-0822
Practice Address - Country:US
Practice Address - Phone:806-798-8820
Practice Address - Fax:806-798-9754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3035TG152WC0802X, 152WP0200X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148340601Medicaid
00125SMedicare PIN