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General NPI Number Information
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NPI Number | 1215072400
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Entity Type | Organization
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Legal Business Name | VIRGINIA EYE SPECIALISTS PC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 03/10/2008
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Provider Practice Location Address
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Address Line | 3660 BOULEVARD
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-1345
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Country | US
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Telephone | 804-243-2020
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Fax | 804-520-2223
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Provider Business Mailing Address
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Address Line | 809 CLUB RIDGE CT
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City | CHESTER
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State | VA
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Zip | 23836-2745
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Country | US
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Telephone | 804-530-0590
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Fax | 804-530-0590
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Authorized Official
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Title or Position | OWNER
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Name | DR. PRANAY GUPTA
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Credential | MD
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Telephone | 804-243-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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