Provider Demographics
NPI:1346450624
Name:TOTAL OPTOMETRIC CARE INCORPORATED
Entity Type:Organization
Organization Name:TOTAL OPTOMETRIC CARE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINH
Authorized Official - Middle Name:THI
Authorized Official - Last Name:HOANG-BRALEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:703-486-2620
Mailing Address - Street 1:2805 COLUMBIA PIKE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-4411
Mailing Address - Country:US
Mailing Address - Phone:703-486-2620
Mailing Address - Fax:703-486-0208
Practice Address - Street 1:2805 COLUMBIA PIKE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-4411
Practice Address - Country:US
Practice Address - Phone:703-486-2620
Practice Address - Fax:703-486-0208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000389152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA259649OtherANTHEM BCBS
VA2781116OtherAETNA
VA293534OtherMAMSI/MDIPA
VA293534OtherALLIANCE PPO
VA51600820OtherPHCS
VAF6910001OtherCAREFIRST BCBS
VA293534OtherUNITED HEALTHCARE
VA293534OtherMAMSI/MDIPA
VA293534OtherALLIANCE PPO
VA=========OtherTRICARE