Organization
CANADIAN EYECARE CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT LUSK (OWNER)
(806) 323-8484
Entity
Organization
Contact information
Practice address
306 MAIN ST, CANADIAN, TX 79014-2215
(806) 323-8484
Mailing address
306 MAIN ST, CANADIAN, TX 79014-2215
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
2073
OK
261Q00000X
Clinic/Center
Primary
4674T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143542201
—
TX
Enumeration date
08/11/2006
Last updated
03/22/2011
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