Provider Demographics
NPI:1538129291
Name:SUBRAMANIAN, ARUN THOPPE (OD FAAO)
Entity Type:Individual
Prefix:DR
First Name:ARUN
Middle Name:THOPPE
Last Name:SUBRAMANIAN
Suffix:
Gender:M
Credentials:OD FAAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 SOUTHLAKE CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27295-9829
Mailing Address - Country:US
Mailing Address - Phone:713-446-9614
Mailing Address - Fax:336-245-4636
Practice Address - Street 1:1635 NC HIGHWAY 66 S STE 155
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-3855
Practice Address - Country:US
Practice Address - Phone:336-992-0010
Practice Address - Fax:336-245-4636
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00450033OtherRAILROAD MEDICARE
NC5905630Medicaid
NC5905630Medicaid
NC2473983AMedicare PIN
NC0156510001Medicare NSC
NC2473983BMedicare PIN