Provider Demographics
NPI:1598829418
Name:DR ALAN L BYRD & ASSOCIATES AT LANDMARK OD PA
Entity Type:Organization
Organization Name:DR ALAN L BYRD & ASSOCIATES AT LANDMARK OD PA
Other - Org Name:MYEYES OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-639-2020
Mailing Address - Street 1:8313 S NC 55 HWY
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:27592-9543
Mailing Address - Country:US
Mailing Address - Phone:919-639-2020
Mailing Address - Fax:919-639-8508
Practice Address - Street 1:5638 NC HIGHWAY 42 W
Practice Address - Street 2:FORTY TWO FORTY PLAZA - SUITE 207
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-7998
Practice Address - Country:US
Practice Address - Phone:919-639-2020
Practice Address - Fax:919-779-6511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1575152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC018M2OtherBLUE CROSS BLUE SHIELD
NC5905414Medicaid
NC018M2OtherBLUE CROSS BLUE SHIELD
NC5802140001Medicare NSC