Provider Demographics
NPI:1386174837
Name:EYEWORKS OPTOMETRY INC
Entity type:Organization
Organization Name:EYEWORKS OPTOMETRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ECK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-841-6549
Mailing Address - Street 1:11 ELLIOT LN
Mailing Address - Street 2:
Mailing Address - City:COTO DE CAZA
Mailing Address - State:CA
Mailing Address - Zip Code:92679-5155
Mailing Address - Country:US
Mailing Address - Phone:630-841-6549
Mailing Address - Fax:
Practice Address - Street 1:7407 MELROSE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-7514
Practice Address - Country:US
Practice Address - Phone:323-653-8255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty