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
Phone: (903) 581-2020
Fax: (903) 509-1492
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679627301 | NPPES |
| Texas | Other | 751573775 | TAX ID |
| Texas | MEDICAID | 019677601 | TAX ID |
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