Provider Demographics
NPI:1124232228
Name:2020 EYE CARE
Entity Type:Organization
Organization Name:2020 EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMIA
Authorized Official - Middle Name:
Authorized Official - Last Name:IDRIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:678-339-0423
Mailing Address - Street 1:10945 STATE BRIDGE RD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-8164
Mailing Address - Country:US
Mailing Address - Phone:678-339-0423
Mailing Address - Fax:
Practice Address - Street 1:10945 STATE BRIDGE RD
Practice Address - Street 2:SUITE 306
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-8164
Practice Address - Country:US
Practice Address - Phone:678-339-0423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT001870152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty