Provider Demographics
NPI:1043240740
Name:BELL, LANG X (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:LANG
Middle Name:X
Last Name:BELL
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6041 INDIAN RIVER ROAD
Mailing Address - Street 2:LANG OPTICAL
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-3803
Mailing Address - Country:US
Mailing Address - Phone:757-424-2030
Mailing Address - Fax:757-424-2030
Practice Address - Street 1:6041 INDIAN RIVER RD
Practice Address - Street 2:LANG OPTICAL
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-3803
Practice Address - Country:US
Practice Address - Phone:757-424-2030
Practice Address - Fax:757-424-2030
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1101002394156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA121833001Medicaid
VA121833001Medicaid
1218330001Medicare NSC