Provider Demographics
NPI:1528698727
Name:HAVEN EYECARE PLLC
Entity type:Organization
Organization Name:HAVEN EYECARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF OPTOMETRY
Authorized Official - Prefix:
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:MATHEW
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-452-6290
Mailing Address - Street 1:9901 W INTERSTATE 10 STE 8031
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-2246
Mailing Address - Country:US
Mailing Address - Phone:210-602-1140
Mailing Address - Fax:210-866-3010
Practice Address - Street 1:9901 W INTERSTATE 10 STE 8031
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2246
Practice Address - Country:US
Practice Address - Phone:347-735-3057
Practice Address - Fax:210-866-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-16
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty