Provider Demographics
NPI:1740056464
Name:2020 FAMILY VISION BH LLC
Entity type:Organization
Organization Name:2020 FAMILY VISION BH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:KAYS
Authorized Official - Last Name:ZAIR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:248-310-8465
Mailing Address - Street 1:30660 W 12 MILE RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3808
Mailing Address - Country:US
Mailing Address - Phone:248-737-3937
Mailing Address - Fax:
Practice Address - Street 1:1611 S OPDYKE RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-1043
Practice Address - Country:US
Practice Address - Phone:248-858-2535
Practice Address - Fax:248-858-2403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-04
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty