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General NPI Number Information
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NPI Number | 1194976969
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Entity Type | Organization
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Legal Business Name | MY VISION CARE PLLC
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Dates
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Enumeration Date | 10/09/2008
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Last Update Date | 10/16/2013
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Provider Practice Location Address
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Address Line | 14130 NOBLEWOOD PLZ UNIT 105
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City | WOODBRIDGE
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State | VA
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Zip | 22193-1464
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Country | US
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Telephone | 703-878-2020
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Fax | 703-878-2020
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Provider Business Mailing Address
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Address Line | 14599 CHARITY CT
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City | WOODBRIDGE
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State | VA
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Zip | 22193-1200
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Country | US
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Telephone | 703-878-2020
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Fax | 703-878-2020
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. MOHAMMAD ASHFAQ
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Credential | O.D
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Telephone | 703-878-2020
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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 | 0618001741
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License Number State | VA
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