Regional Eyecare Associates INC
Optometrist in O Fallon, MO. Organization (NPI-2).
NPI number1043380652
StatusActive
Last updated in NPPESOct 20, 2025
Details
- NPI
- 1043380652
- Entity type
- Organization (NPI-2)
- Legal business name
- Regional Eyecare Associates INC
- Organization subpart
- No
- Enumeration date
- Nov 9, 2006
- Certification date
- Oct 20, 2025
- Last updated
- Oct 20, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | T03134 | MO | Yes |
| 152W00000X | Optometrist | 2003015589 | MO | |
| 152W00000X | Optometrist | T03118 | MO |
Practice location
3013 Winghaven BlvdO Fallon, MO 63368-3600
Phone 636-561-3937 · Fax 636-561-4068
Mailing address
3013 Winghaven BlvdO Fallon, MO 63368-3600
Phone 636-561-3937 · Fax 636-561-4068
Authorized official
Lisa M Mackey
Od Vp
6365613937
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All 34 Optometrist providers in O Fallon · All 1,566 providers in O Fallon
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