Provider Demographics
NPI:1720804933
Name:ROLLING HILLS EYE CARE PLLC
Entity type:Organization
Organization Name:ROLLING HILLS EYE CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:R
Authorized Official - Last Name:DALE
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:253-549-3074
Mailing Address - Street 1:700 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BLANCO
Mailing Address - State:TX
Mailing Address - Zip Code:78606-5569
Mailing Address - Country:US
Mailing Address - Phone:830-554-9332
Mailing Address - Fax:
Practice Address - Street 1:700 4TH ST
Practice Address - Street 2:
Practice Address - City:BLANCO
Practice Address - State:TX
Practice Address - Zip Code:78606-5569
Practice Address - Country:US
Practice Address - Phone:253-549-3074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-03
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty