Provider Demographics
NPI:1093851545
Name:JOHN VEIGA, MD PLLC
Entity Type:Organization
Organization Name:JOHN VEIGA, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:VEIGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-556-0892
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:KELSO
Mailing Address - State:WA
Mailing Address - Zip Code:98626-0086
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10315 SILVERDALE WAY NW
Practice Address - Street 2:PRO-OPTIX EYE CENTER
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7670
Practice Address - Country:US
Practice Address - Phone:360-698-4948
Practice Address - Fax:360-698-4948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty