Provider Demographics
NPI:1386186138
Name:VISUAL HEALTH DOCTORS OF OPTOMETRY
Entity Type:Organization
Organization Name:VISUAL HEALTH DOCTORS OF OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SEEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-273-6323
Mailing Address - Street 1:6828 SPRINGFIELD MALL
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-1720
Mailing Address - Country:US
Mailing Address - Phone:703-971-2021
Mailing Address - Fax:703-971-2017
Practice Address - Street 1:6828 SPRINGFIELD MALL
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-1720
Practice Address - Country:US
Practice Address - Phone:703-971-2021
Practice Address - Fax:703-971-2017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty