Provider Demographics
NPI:1720169220
Name:DR ALAN L BYRD AND ASSOCIATES OF ANGIER OD PA
Entity Type:Organization
Organization Name:DR ALAN L BYRD AND ASSOCIATES OF ANGIER OD PA
Other - Org Name:MYEYES OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-639-2020
Mailing Address - Street 1:8313 S NC 55 HWY
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:27592-9543
Mailing Address - Country:US
Mailing Address - Phone:919-639-2020
Mailing Address - Fax:919-639-8508
Practice Address - Street 1:8313 S NC 55 HWY
Practice Address - Street 2:
Practice Address - City:WILLOW SPRING
Practice Address - State:NC
Practice Address - Zip Code:27592-9543
Practice Address - Country:US
Practice Address - Phone:919-639-2020
Practice Address - Fax:919-639-8508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC017ETOtherBLUE CROSS BLUE SHIELD
NC5901195Medicaid
NC5524370001Medicare NSC
NC017ETOtherBLUE CROSS BLUE SHIELD