Provider Demographics
NPI:1659493930
Name:SOHI EYE CARE OD PA
Entity Type:Organization
Organization Name:SOHI EYE CARE OD PA
Other - Org Name:EYECARECENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BALPREET
Authorized Official - Middle Name:
Authorized Official - Last Name:SOHI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-872-1648
Mailing Address - Street 1:3901 CAPITAL BLVD
Mailing Address - Street 2:SUITE 113
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-3488
Mailing Address - Country:US
Mailing Address - Phone:919-872-1648
Mailing Address - Fax:919-341-7021
Practice Address - Street 1:3901 CAPITAL BLVD
Practice Address - Street 2:SUITE 113
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-3488
Practice Address - Country:US
Practice Address - Phone:919-872-1648
Practice Address - Fax:919-341-7021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5906862Medicaid
NC019CHOtherBCBS GROUP
NC019CHOtherBCBS GROUP
NC5906862Medicaid