Provider Demographics
NPI:1497911481
Name:BRIAN M. TERUYA, OD AND MARK S. TERUYA, OD OPTOMETRY
Entity Type:Organization
Organization Name:BRIAN M. TERUYA, OD AND MARK S. TERUYA, OD OPTOMETRY
Other - Org Name:EYECARE CONSULTANTS HAWAII
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GEN. PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:TERUYA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:808-734-4343
Mailing Address - Street 1:3221 WAIALAE AVE
Mailing Address - Street 2:SUITE 340
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5842
Mailing Address - Country:US
Mailing Address - Phone:808-734-4343
Mailing Address - Fax:808-734-3930
Practice Address - Street 1:3221 WAIALAE AVE
Practice Address - Street 2:SUITE 340
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5842
Practice Address - Country:US
Practice Address - Phone:808-734-4343
Practice Address - Fax:808-734-3930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD176152W00000X
HIOD167152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty