Healthcare Provider Details

I. General information

NPI: 1780515734
Provider Name (Legal Business Name): METRO EYES VISION CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 MAPLE AVE E
VIENNA VA
22180-4629
US

IV. Provider business mailing address

260 MAPLE AVE E
VIENNA VA
22180-4629
US

V. Phone/Fax

Practice location:
  • Phone: 703-255-1502
  • Fax:
Mailing address:
  • Phone: 703-255-1502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: GOOYA GOUDARZI
Title or Position: DOCTOR OF OPTOMETRY
Credential: OD
Phone: 703-255-1502