Provider Demographics
NPI:1992277123
Name:SUPERIOR EYE CARE PC
Entity type:Organization
Organization Name:SUPERIOR EYE CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:713-591-7918
Mailing Address - Street 1:5912 CONVAIR DR STE 208
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-1269
Mailing Address - Country:US
Mailing Address - Phone:817-880-7917
Mailing Address - Fax:817-378-4707
Practice Address - Street 1:5912 CONVAIR DR STE 208
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-1269
Practice Address - Country:US
Practice Address - Phone:817-880-7917
Practice Address - Fax:817-378-4707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty