Provider Demographics
NPI:1093181455
Name:DESTINY EYE CARE, PC
Entity Type:Organization
Organization Name:DESTINY EYE CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DESARAE
Authorized Official - Middle Name:
Authorized Official - Last Name:BONDS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:678-770-9941
Mailing Address - Street 1:600 GARSON DR NE APT 10307
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-6215
Mailing Address - Country:US
Mailing Address - Phone:678-770-9941
Mailing Address - Fax:404-228-9785
Practice Address - Street 1:6631 ROSWELL RD STE G
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-3179
Practice Address - Country:US
Practice Address - Phone:404-843-8248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-19
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center