Provider Demographics
NPI:1891378030
Name:VERONICA FOWLER OD & ASSOCIATES PC
Entity Type:Organization
Organization Name:VERONICA FOWLER OD & ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:BUTRESE
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:757-825-1804
Mailing Address - Street 1:211 STARLING CIR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-0136
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1900 CUNNINGHAM DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-4260
Practice Address - Country:US
Practice Address - Phone:757-825-1804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty