Bennett, Eugene

Bennett, Eugene is an sole proprietor health care provider with primary practice located at 4824 S Broadway Ave , Tyler TX 75703-1312. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bennett, Eugene can be contacted via phone (903) 581-2020.

Contact Information

Primary practice address
4824 S Broadway Ave Tyler TX 75703-1312
Fax: (903) 509-1492
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1848 Texas

Profile Details

NPI number 1679627301
LBN Legal business name Bennett, Eugene
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 22nd, 2007
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679627301 NPPES
Texas Other 751573775 TAX ID
Texas MEDICAID 019677601 TAX ID

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