Provider Demographics
NPI:1689847279
Name:DEBORAH C WESTON OD PA
Entity Type:Organization
Organization Name:DEBORAH C WESTON OD PA
Other - Org Name:TOWN CENTER OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:C
Authorized Official - Last Name:WESTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-384-0266
Mailing Address - Street 1:1673 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3663
Mailing Address - Country:US
Mailing Address - Phone:954-384-0266
Mailing Address - Fax:954-384-0214
Practice Address - Street 1:1673 MARKET ST
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3663
Practice Address - Country:US
Practice Address - Phone:954-384-0266
Practice Address - Fax:954-384-0214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-04
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL003315152W00000X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty