| Canadian Eyecare Clinic, P.c. | |
|
306 Main St Canadian TX 79014-2215 | |
| (806) 323-8484 | |
| Not Available |
| Full Name | Canadian Eyecare Clinic, P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 306 Main St, Canadian, Texas |
| Authorized Official Name and Position | Robert Lusk (OWNER) |
| Authorized Official Contact | 8063238484 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Canadian Eyecare Clinic, P.c. 306 Main St Canadian TX 79014-2215 Ph: () - | Canadian Eyecare Clinic, P.c. 306 Main St Canadian TX 79014-2215 Ph: (806) 323-8484 |
| NPI Number | 1285645218 |
|---|---|
| Provider Enumeration Date | 08/11/2006 |
| Last Update Date | 03/22/2011 |
| Medicare PECOS PAC ID | 9830164441 |
|---|---|
| Medicare Enrollment ID | O20040827000576 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285645218 | NPI | - | NPPES |
| 143542201 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2073 (Oklahoma) | Secondary |
| 261Q00000X | Clinic/center | 4674T (Texas) | Primary |
| Provider Name | Robert G Lusk |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1902817927 PECOS PAC ID: 3072588680 Enrollment ID: I20140521000226 |
Hemphill County Hospital District Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1010 S 4th St, Canadian, TX 79014 Phone: 806-323-8882 | |
Derm Nuvo Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 215 Main St, Canadian, TX 79014 Phone: 806-323-8365 |