Provider Demographics
NPI:1124121587
Name:WSK EYE ASSOCIATES PA
Entity type:Organization
Organization Name:WSK EYE ASSOCIATES PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-436-5040
Mailing Address - Street 1:1850 LAKEPOINTE DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-6443
Mailing Address - Country:US
Mailing Address - Phone:972-436-5040
Mailing Address - Fax:972-221-0249
Practice Address - Street 1:1850 LAKEPOINTE DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-6443
Practice Address - Country:US
Practice Address - Phone:972-436-5040
Practice Address - Fax:972-221-0249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126003601Medicaid
TX126003604Medicaid
79AXMedicare ID - Type Unspecified
91AXMedicare ID - Type Unspecified