Provider Demographics
NPI:1194714212
Name:EXCELLENT EYES, P.C.
Entity type:Organization
Organization Name:EXCELLENT EYES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:SCHAUER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:701-663-0313
Mailing Address - Street 1:107 6TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-2609
Mailing Address - Country:US
Mailing Address - Phone:701-663-0313
Mailing Address - Fax:701-663-1604
Practice Address - Street 1:107 6TH AVE NW
Practice Address - Street 2:
Practice Address - City:MANDAN
Practice Address - State:ND
Practice Address - Zip Code:58554-2609
Practice Address - Country:US
Practice Address - Phone:701-663-0313
Practice Address - Fax:701-663-1604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-20
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND703152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND60210Medicaid
ND60315Medicaid
ND60315Medicaid
ND0377640001Medicare NSC
ND8862Medicare PIN