Provider Demographics
NPI:1235821216
Name:HOLLY SPRINGS EYECARE PLLC
Entity Type:Organization
Organization Name:HOLLY SPRINGS EYECARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:662-473-2181
Mailing Address - Street 1:302 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:WATER VALLEY
Mailing Address - State:MS
Mailing Address - Zip Code:38965-3032
Mailing Address - Country:US
Mailing Address - Phone:662-473-2181
Mailing Address - Fax:662-473-2161
Practice Address - Street 1:302 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:WATER VALLEY
Practice Address - State:MS
Practice Address - Zip Code:38965-3032
Practice Address - Country:US
Practice Address - Phone:662-473-2181
Practice Address - Fax:662-473-2161
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOLLY SPRINGS EYECARE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty