Provider Demographics
NPI:1538350608
Name:STONEBRIDGE EYE, P.C.
Entity type:Organization
Organization Name:STONEBRIDGE EYE, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUACH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:469-569-2782
Mailing Address - Street 1:3109 S CUSTER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-7170
Mailing Address - Country:US
Mailing Address - Phone:469-569-2782
Mailing Address - Fax:214-705-6002
Practice Address - Street 1:3109 S CUSTER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-7170
Practice Address - Country:US
Practice Address - Phone:469-569-2782
Practice Address - Fax:214-705-6002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6248T152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty