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General NPI Number Information
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NPI Number | 1023375722
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Entity Type | Organization
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Legal Business Name | EYE STYLES LLC
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Dates
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Enumeration Date | 04/18/2012
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Last Update Date | 04/18/2012
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Provider Practice Location Address
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Address Line | 5530 WINDWARD PKWY SUITE 1220
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City | ALPHARETTA
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State | GA
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Zip | 30004-8969
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Country | US
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Telephone | 678-867-9868
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Fax |
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Provider Business Mailing Address
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Address Line | 5530 WINDWARD PKWY SUITE 1220
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City | ALPHARETTA
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State | GA
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Zip | 30004-8969
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Country | US
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Telephone | 678-867-9868
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MAMTA PATEL
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Credential | O.D.
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Telephone | 770-362-4721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2530
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License Number State | GA
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