Healthcare Provider Details

I. General information

NPI: 1720512221
Provider Name (Legal Business Name): ERIC B LARIOS OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5002 CROSSINGS CIR STE 240
MOUNT JULIET TN
37122-8593
US

IV. Provider business mailing address

PO BOX 306307
NASHVILLE TN
37230-6307
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-2001
  • Fax: 423-508-7338
Mailing address:
  • Phone: 423-424-0383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3372
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: