Provider Demographics
NPI:1649803131
Name:CITY OPTOMETRY PLLC
Entity type:Organization
Organization Name:CITY OPTOMETRY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:NEHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:VIRANI-ALI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:336-505-1704
Mailing Address - Street 1:10415 W. GRAND PKWY. S
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407
Mailing Address - Country:US
Mailing Address - Phone:336-505-1704
Mailing Address - Fax:346-292-5297
Practice Address - Street 1:10415 W. GRAND PKWY. S
Practice Address - Street 2:SUITE 100B
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407
Practice Address - Country:US
Practice Address - Phone:336-505-1704
Practice Address - Fax:346-292-5297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-13
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty