Healthcare Provider Details

I. General information

NPI: 1205577210
Provider Name (Legal Business Name): HOLLY SPRINGS EYE AND LASER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

242 S MAIN ST STE 110
HOLLY SPRINGS NC
27540-6052
US

IV. Provider business mailing address

201 S MCPHERSON CHURCH RD STE 106
FAYETTEVILLE NC
28303-4913
US

V. Phone/Fax

Practice location:
  • Phone: 919-689-8920
  • Fax: 919-689-8967
Mailing address:
  • Phone: 919-689-8920
  • Fax: 919-689-8967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. FARAAZ KHAN
Title or Position: OPHTHALMOLOGIST
Credential: MD
Phone: 919-689-8920