Provider Demographics
NPI:1295334001
Name:EYE ROOM PLLC
Entity type:Organization
Organization Name:EYE ROOM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-748-0886
Mailing Address - Street 1:17659 FISHTRAP ROAD
Mailing Address - Street 2:STE 30
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078
Mailing Address - Country:US
Mailing Address - Phone:469-715-0775
Mailing Address - Fax:
Practice Address - Street 1:17659 FISHTRAP ROAD
Practice Address - Street 2:STE 30
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-7507
Practice Address - Country:US
Practice Address - Phone:469-715-0775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty