Provider Demographics
NPI:1972080869
Name:NV OPTOMETRY
Entity Type:Organization
Organization Name:NV OPTOMETRY
Other - Org Name:PEEPERS OF BOWIE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:NISHITH
Authorized Official - Middle Name:G
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:240-643-1056
Mailing Address - Street 1:1352 CHAPEL CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054-1978
Mailing Address - Country:US
Mailing Address - Phone:240-643-1056
Mailing Address - Fax:
Practice Address - Street 1:2626 BRANDERMILL BLVD
Practice Address - Street 2:
Practice Address - City:GAMBRILLS
Practice Address - State:MD
Practice Address - Zip Code:21054-1651
Practice Address - Country:US
Practice Address - Phone:410-451-9499
Practice Address - Fax:301-261-6584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2261152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty