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General NPI Number Information
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NPI Number | 1669924098
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Entity Type | Organization
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Legal Business Name | RALESHIA NIX, P.C.
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Dates
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Enumeration Date | 11/02/2016
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Last Update Date | 11/07/2016
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Provider Practice Location Address
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Address Line | 92 PLAZA LN
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City | OXFORD
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State | AL
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Zip | 36203-2440
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Country | US
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Telephone | 256-835-4806
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Fax | 256-835-4988
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Provider Business Mailing Address
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Address Line | 191 BENTBROOK CIR
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City | OXFORD
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State | AL
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Zip | 36203-8303
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Country | US
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Telephone | 256-835-4806
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Fax | 256-835-4988
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. RALESHIA NIX BURKE
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Credential | O.D.
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Telephone | 256-835-4806
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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 | S-911-TA-478
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License Number State | AL
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