Provider Demographics
NPI:1285055905
Name:EYE & OCULAR SURFACE CENTER OF TEXAS LLC
Entity type:Organization
Organization Name:EYE & OCULAR SURFACE CENTER OF TEXAS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:DI PASCUALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:915-538-3171
Mailing Address - Street 1:2900 PERSHING DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-2403
Mailing Address - Country:US
Mailing Address - Phone:915-538-3171
Mailing Address - Fax:
Practice Address - Street 1:2900 PERSHING DR
Practice Address - Street 2:SUITE A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-2403
Practice Address - Country:US
Practice Address - Phone:915-538-3171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-23
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty