Healthcare Provider Details

I. General information

NPI: 1538567375
Provider Name (Legal Business Name): EYE CENTER OF NASHVILLE UAP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2014
Last Update Date: 01/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

15305 DALLAS PKWY SUITE 1600
ADDISON TX
75001-4637
US

V. Phone/Fax

Practice location:
  • Phone: 615-329-9023
  • Fax:
Mailing address:
  • Phone: 972-713-3547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. KIMBERLY MICHELLE HARPER
Title or Position: OFFICER / ANESTHESIA PROGRAM MNGR
Credential:
Phone: 972-713-3547