Provider Demographics
NPI:1134137086
Name:PREMIER EYECARE, ANGELA TSAI, O.D. AND ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:PREMIER EYECARE, ANGELA TSAI, O.D. AND ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:TSAI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:540-373-3021
Mailing Address - Street 1:230 BUTLER ROAD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405
Mailing Address - Country:US
Mailing Address - Phone:540-373-3021
Mailing Address - Fax:540-373-5565
Practice Address - Street 1:230 BUTLER ROAD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405
Practice Address - Country:US
Practice Address - Phone:540-373-3021
Practice Address - Fax:540-373-5565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000130152W00000X
VA0618000447152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA061203OtherANTHEM BCBS
VA410011188OtherRAILROAD MEDICARE
VA410011189OtherRAILROAD MEDICARE
VA9203915Medicaid
VA010302005Medicaid
VA010302005Medicaid
VA061203OtherANTHEM BCBS
T21372Medicare UPIN
VA410000656Medicare ID - Type Unspecified
VA9203915Medicaid
VA010302005Medicaid
VA2159329OtherOPTIMUM CHOICE MDIPA MAMS
VA410000610Medicare ID - Type Unspecified