Provider Demographics
NPI:1598913436
Name:IRIS EYECARE SERVICES, PLLC
Entity Type:Organization
Organization Name:IRIS EYECARE SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:540-722-6346
Mailing Address - Street 1:3363 SHAWNEE DR
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-6300
Mailing Address - Country:US
Mailing Address - Phone:540-722-6346
Mailing Address - Fax:
Practice Address - Street 1:3363 SHAWNEE DR
Practice Address - Street 2:SUITE 1A
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-6300
Practice Address - Country:US
Practice Address - Phone:540-722-6346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000575152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA410000751OtherMEDICARE ID
VAT31268Medicare UPIN