Healthcare Provider Details
I. General information
NPI: 1487734570
Provider Name (Legal Business Name): TEMAS EYE CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/16/2006
Last Update Date: 03/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
725 HIGHLAND OAKS DR SUITE 101
WINSTON SALEM NC
27103-7109
US
IV. Provider business mailing address
725 HIGHLAND OAKS DR SUITE 101
WINSTON SALEM NC
27103-7109
US
V. Phone/Fax
- Phone: 336-659-8180
- Fax: 336-659-8363
- Phone: 336-659-8180
- Fax: 336-659-8363
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GREGORY
PETER
TEMAS
Title or Position: PRESIDENT
Credential: MD
Phone: 336-659-8180