Provider Demographics
NPI:1720397227
Name:EYE HEALTH PROFESSIONALS, INC
Entity Type:Organization
Organization Name:EYE HEALTH PROFESSIONALS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RENA
Authorized Official - Middle Name:I
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:205-482-1337
Mailing Address - Street 1:160 POLO DOWNS
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:AL
Mailing Address - Zip Code:35043-7600
Mailing Address - Country:US
Mailing Address - Phone:205-482-1337
Mailing Address - Fax:
Practice Address - Street 1:165 VAUGHAN LN
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35125-7808
Practice Address - Country:US
Practice Address - Phone:205-338-5318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-C35-TA-872152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty