Provider Demographics
NPI:1538549761
Name:TRUEVISION COMPLETE EYE-CARE P.A.
Entity type:Organization
Organization Name:TRUEVISION COMPLETE EYE-CARE P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:IREDIA
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:EKUKPE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:214-941-9600
Mailing Address - Street 1:911 WYNNEWOOD VILLAGE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75224
Mailing Address - Country:US
Mailing Address - Phone:214-941-9600
Mailing Address - Fax:214-941-9623
Practice Address - Street 1:911 WYNNEWOOD VILLAGE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224
Practice Address - Country:US
Practice Address - Phone:214-941-9600
Practice Address - Fax:214-941-9623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6330TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154313402Medicaid
TXU92940Medicare UPIN