Healthcare Provider Details

I. General information

NPI: 1124940192
Provider Name (Legal Business Name): RAJ OPTOMETRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 HWY 9 BYPASS WEST
LANCASTER SC
29720-9317
US

IV. Provider business mailing address

5014 KETTERING AVE
FORT MILL SC
29715-1410
US

V. Phone/Fax

Practice location:
  • Phone: 803-286-4826
  • Fax:
Mailing address:
  • Phone: 980-800-4440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RAKSHA RAJ
Title or Position: OPTOMETRIST
Credential: OD
Phone: 980-800-4440