Healthcare Provider Details

I. General information

NPI: 1427003052
Provider Name (Legal Business Name): EYE SURGERY CENTER OF NASHVILLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 25TH AVE N STE 105
NASHVILLE TN
37203-1515
US

IV. Provider business mailing address

14201 DALLAS PKWY
DALLAS TX
75254-2916
US

V. Phone/Fax

Practice location:
  • Phone: 615-329-9023
  • Fax: 615-329-1665
Mailing address:
  • Phone: 972-763-3859
  • Fax: 972-920-3445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number0000000013
License Number StateTN

VIII. Authorized Official

Name: KRISTEN O'CONNOR
Title or Position: OFFICER/AUTHORIZED OFFICIAL
Credential:
Phone: 615-376-7315