Healthcare Provider Details

I. General information

NPI: 1114872835
Provider Name (Legal Business Name): VIRGINIA EYE CONSULTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1788 REPUBLIC RD
VIRGINIA BEACH VA
23454-4552
US

IV. Provider business mailing address

1788 REPUBLIC RD
VIRGINIA BEACH VA
23454-4552
US

V. Phone/Fax

Practice location:
  • Phone: 757-483-0400
  • Fax: 757-686-0947
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH PRAVOOT GIRA
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 314-909-0633