Provider Demographics
NPI:1326439001
Name:XAVIER EYE CARE
Entity Type:Organization
Organization Name:XAVIER EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIDINMA
Authorized Official - Middle Name:UGONMA
Authorized Official - Last Name:NWACHUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-875-0753
Mailing Address - Street 1:2601 LEGACY WALK CT
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017-7833
Mailing Address - Country:US
Mailing Address - Phone:770-875-0753
Mailing Address - Fax:
Practice Address - Street 1:2037 ROSEBUD RD
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:GA
Practice Address - Zip Code:30017-1226
Practice Address - Country:US
Practice Address - Phone:470-709-5953
Practice Address - Fax:770-852-8761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002846152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty