Provider Demographics
NPI:1831245356
Name:DUGAN EYE INSTITUTE
Entity type:Organization
Organization Name:DUGAN EYE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:DUGAN
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:361-884-8878
Mailing Address - Street 1:PO BOX 60068
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-0068
Mailing Address - Country:US
Mailing Address - Phone:361-884-8878
Mailing Address - Fax:361-884-2020
Practice Address - Street 1:1333 3RD ST
Practice Address - Street 2:STE 100
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2200
Practice Address - Country:US
Practice Address - Phone:361-884-8878
Practice Address - Fax:361-884-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE1306207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00L02LOtherBLUE CROSS BLUE SHIELD
TX74-2021064OtherTAX ID
TX083614001Medicaid
TX083614001Medicaid
TX083614001Medicaid