Healthcare Provider Details

I. General information

NPI: 1568327765
Provider Name (Legal Business Name): FAMILY OPTICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 S FUQUAY AVE STE 120
FUQUAY VARINA NC
27526-2254
US

IV. Provider business mailing address

209 S FUQUAY AVE STE 120
FUQUAY VARINA NC
27526-2254
US

V. Phone/Fax

Practice location:
  • Phone: 919-567-0059
  • Fax: 919-567-0079
Mailing address:
  • Phone: 919-567-0059
  • Fax: 919-567-0079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156FC0800X
TaxonomyContact Lens Technician/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code156FC0801X
TaxonomyContact Lens Fitter
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: HEATHER ALLEN
Title or Position: OWNER
Credential: LDO, ABOC, NCLEC
Phone: 919-567-0059