Provider Demographics
NPI:1669924098
Name:RALESHIA NIX, P.C.
Entity type:Organization
Organization Name:RALESHIA NIX, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RALESHIA
Authorized Official - Middle Name:NIX
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-835-4806
Mailing Address - Street 1:191 BENTBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-8303
Mailing Address - Country:US
Mailing Address - Phone:256-835-4806
Mailing Address - Fax:256-835-4988
Practice Address - Street 1:92 PLAZA LN
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-2440
Practice Address - Country:US
Practice Address - Phone:256-835-4806
Practice Address - Fax:256-835-4988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-02
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-911-TA-478152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty