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General NPI Number Information
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NPI Number | 1649408253
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Entity Type | Organization
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Legal Business Name | VISTA EYE SPECIALISTS PC
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Dates
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Enumeration Date | 06/23/2009
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Last Update Date | 08/14/2009
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Provider Practice Location Address
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Address Line | 4207 GERMANNA HWY STE C LAKE OF THE WOODS PLAZA II
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City | LOCUST GROVE
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State | VA
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Zip | 22508-2040
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Country | US
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Telephone | 540-972-6786
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Fax | 540-972-6788
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Provider Business Mailing Address
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Address Line | 4207 GERMANNA HWY STE C LAKE OF THE WOODS PLAZA II
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City | LOCUST GROVE
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State | VA
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Zip | 22508-2040
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Country | US
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Telephone | 540-972-6786
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Fax | 540-972-6788
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BINOY R JANI
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Credential |
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Telephone | 540-972-6786
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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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