Healthcare Provider Details

I. General information

NPI: 1033026935
Provider Name (Legal Business Name): FRIENDLY EYES OPTOMETRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 BOSTON DR SPC D3
BURLINGTON NC
27215-8232
US

IV. Provider business mailing address

534 E ZARAGOZA ST APT 7
PENSACOLA FL
32502-6100
US

V. Phone/Fax

Practice location:
  • Phone: 336-586-1902
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BARRY M CONCOOL
Title or Position: MD
Credential:
Phone: 267-566-4109