Provider Demographics
NPI:1487726931
Name:SEEBACH INC.
Entity type:Organization
Organization Name:SEEBACH INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONAVON
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-362-0201
Mailing Address - Street 1:6014 EASTRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-5056
Mailing Address - Country:US
Mailing Address - Phone:432-362-0201
Mailing Address - Fax:432-362-3293
Practice Address - Street 1:6014 EASTRIDGE RD
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-5056
Practice Address - Country:US
Practice Address - Phone:432-362-0201
Practice Address - Fax:432-362-3293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDR4059332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5702050001Medicare ID - Type Unspecified