Provider Demographics
NPI:1831710425
Name:GEMSTONE EYE CARE
Entity type:Organization
Organization Name:GEMSTONE EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FAUSTA
Authorized Official - Middle Name:
Authorized Official - Last Name:TABE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:202-294-5768
Mailing Address - Street 1:7135 STAPLES MILL RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-4104
Mailing Address - Country:US
Mailing Address - Phone:804-264-7095
Mailing Address - Fax:804-264-7097
Practice Address - Street 1:7135 STAPLES MILL RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-4104
Practice Address - Country:US
Practice Address - Phone:804-264-7095
Practice Address - Fax:804-264-7097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-05
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty