Provider Demographics
NPI:1043337678
Name:SATHER EYE CLINIC AND OPTICAL, P.C.
Entity type:Organization
Organization Name:SATHER EYE CLINIC AND OPTICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:SATHER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:406-587-9610
Mailing Address - Street 1:1727 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-4913
Mailing Address - Country:US
Mailing Address - Phone:406-587-9610
Mailing Address - Fax:406-587-8369
Practice Address - Street 1:1727 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-4913
Practice Address - Country:US
Practice Address - Phone:406-587-9610
Practice Address - Fax:406-587-8369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT439152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT26690OtherBLUE CROSS BLUE SHIELD
MT0484874Medicaid
MT00083774Medicare ID - Type UnspecifiedOLD CORPORATE MEDICARE #
MT0484874Medicaid