Provider Demographics
NPI:1386740876
Name:CORNEA ASSOCIATES OF TEXAS PA
Entity type:Organization
Organization Name:CORNEA ASSOCIATES OF TEXAS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:TYRONE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-692-0146
Mailing Address - Street 1:PO BOX 730486
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-0486
Mailing Address - Country:US
Mailing Address - Phone:972-791-1224
Mailing Address - Fax:972-819-0050
Practice Address - Street 1:1101 6TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4306
Practice Address - Country:US
Practice Address - Phone:817-850-9282
Practice Address - Fax:817-850-9218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0071PCOtherBCBS
TX1845851 02Medicaid
TX0071PCOtherBCBS
TX562486Medicare PIN