Healthcare Provider Details

I. General information

NPI: 1023256617
Provider Name (Legal Business Name): PARRIS-CASTORO EYE CARE CENTER, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2009
Last Update Date: 02/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 BOULTON ST
BEL AIR MD
21014-4255
US

IV. Provider business mailing address

620 BOULTON ST
BEL AIR MD
21014-4255
US

V. Phone/Fax

Practice location:
  • Phone: 410-893-0480
  • Fax: 410-893-9796
Mailing address:
  • Phone: 410-893-0480
  • Fax: 410-893-9796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: PATTY ROBBINS
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 410-399-8432