Provider Demographics
NPI:1679745392
Name:MARKOSE EYE ASSOCIATES INC.
Entity type:Organization
Organization Name:MARKOSE EYE ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOSE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:469-549-0987
Mailing Address - Street 1:190 E ROUND GROVE RD
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-8301
Mailing Address - Country:US
Mailing Address - Phone:469-549-0987
Mailing Address - Fax:469-549-0989
Practice Address - Street 1:190 E ROUND GROVE RD
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8301
Practice Address - Country:US
Practice Address - Phone:469-549-0987
Practice Address - Fax:469-549-0989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6704T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty