Provider Demographics
NPI:1962400168
Name:EYE CARE & SURGERY PC
Entity type:Organization
Organization Name:EYE CARE & SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HELMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-772-7171
Mailing Address - Street 1:1960 ELECTRIC RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-1621
Mailing Address - Country:US
Mailing Address - Phone:540-772-7171
Mailing Address - Fax:540-774-8299
Practice Address - Street 1:1960 ELECTRIC RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-1621
Practice Address - Country:US
Practice Address - Phone:540-772-7171
Practice Address - Fax:540-774-8299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207W00000X, 261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Not Answered261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C-03075Medicare ID - Type Unspecified