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General NPI Number Information
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NPI Number | 1568327765
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Entity Type | Organization
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Legal Business Name | FAMILY OPTICAL LLC
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Dates
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Enumeration Date | 12/19/2025
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 209 S FUQUAY AVE STE 120
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City | FUQUAY VARINA
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State | NC
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Zip | 27526-2254
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Country | US
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Telephone | 919-567-0059
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Fax | 919-567-0079
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Provider Business Mailing Address
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Address Line | 209 S FUQUAY AVE STE 120
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City | FUQUAY VARINA
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State | NC
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Zip | 27526-2254
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Country | US
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Telephone | 919-567-0059
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Fax | 919-567-0079
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Authorized Official
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Title or Position | OWNER
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Name | HEATHER ALLEN
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Credential | LDO, ABOC, NCLEC
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Telephone | 919-567-0059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FC0800X
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Taxonomy Name | Contact Lens Technician/Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156FC0801X
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Taxonomy Name | Contact Lens Fitter
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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