Provider Demographics
NPI:1053837435
Name:AYNSLEY GIRARDEAU OD PLLC
Entity Type:Organization
Organization Name:AYNSLEY GIRARDEAU OD PLLC
Other - Org Name:MINT HILL EYE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AYNSLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRARDEAU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:704-937-1444
Mailing Address - Street 1:7014 TUTOR STREET
Mailing Address - Street 2:SUITE C
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227
Mailing Address - Country:US
Mailing Address - Phone:704-937-1444
Mailing Address - Fax:
Practice Address - Street 1:7014 TUTOR STREET
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227
Practice Address - Country:US
Practice Address - Phone:704-937-1444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-17
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2442152W00000X, 152WC0802X, 152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Single Specialty