Provider Demographics
NPI:1700586542
Name:THE GLAUCOMA CENTER, P.C.
Entity Type:Organization
Organization Name:THE GLAUCOMA CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALYSON
Authorized Official - Middle Name:L
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-860-1090
Mailing Address - Street 1:17001 SCIENCE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4330
Mailing Address - Country:US
Mailing Address - Phone:301-860-1090
Mailing Address - Fax:301-860-1095
Practice Address - Street 1:17001 SCIENCE DR STE 120
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4330
Practice Address - Country:US
Practice Address - Phone:301-860-1090
Practice Address - Fax:301-860-1095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-09
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty