Provider Demographics
NPI:1629670690
Name:HIGHLANDS OPTOMETRY, PLLC
Entity Type:Organization
Organization Name:HIGHLANDS OPTOMETRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:276-466-4227
Mailing Address - Street 1:1701 EUCLID AVE STE D
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24201-3700
Mailing Address - Country:US
Mailing Address - Phone:276-466-4227
Mailing Address - Fax:276-466-3937
Practice Address - Street 1:1701 EUCLID AVE STE D
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24201-3700
Practice Address - Country:US
Practice Address - Phone:276-466-4227
Practice Address - Fax:276-466-3937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty