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General NPI Number Information
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NPI Number | 1578476552
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Entity Type | Organization
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Legal Business Name | GASTON EYE SURGERY CENTER
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Dates
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Enumeration Date | 09/23/2026
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Last Update Date | 09/23/2026
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Provider Practice Location Address
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Address Line | 2325 ABERDEEN BLVD STE B
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City | GASTONIA
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State | NC
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Zip | 28054-0642
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Country | US
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Telephone | 704-853-3937
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Fax |
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Provider Business Mailing Address
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Address Line | 2325 ABERDEEN BLVD STE A
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City | GASTONIA
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State | NC
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Zip | 28054-0642
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Country | US
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Telephone | 704-853-3937
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Fax | 704-853-8029
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/OWNER
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Name | BOBBY K MCCULLEN JR.
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Credential | MD
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Telephone | 704-853-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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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 | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number |
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License Number State |
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