Provider Demographics
NPI:1871019042
Name:SOUTHPOINT VISION, CHRISTY BYRD, OD, PLLC
Entity Type:Organization
Organization Name:SOUTHPOINT VISION, CHRISTY BYRD, OD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-572-1200
Mailing Address - Street 1:8202 RENAISSANCE PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6694
Mailing Address - Country:US
Mailing Address - Phone:919-572-1200
Mailing Address - Fax:
Practice Address - Street 1:8202 RENAISSANCE PKWY STE 104
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6694
Practice Address - Country:US
Practice Address - Phone:919-572-1200
Practice Address - Fax:919-572-1200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-18
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1617152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890915JMedicaid