Provider Demographics
NPI:1831894476
Name:RICHARDSON OPTOMETRIC SERVICES LLC
Entity type:Organization
Organization Name:RICHARDSON OPTOMETRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDMUND
Authorized Official - Middle Name:NATHANIEL
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-414-1548
Mailing Address - Street 1:10499 WHITE ASH TRL
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-2659
Mailing Address - Country:US
Mailing Address - Phone:330-414-1548
Mailing Address - Fax:
Practice Address - Street 1:500 SOUTHPARK CTR # CL316
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-9320
Practice Address - Country:US
Practice Address - Phone:440-238-0716
Practice Address - Fax:440-238-3369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty