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General NPI Number Information
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NPI Number | 1740167378
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Entity Type | Individual
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Provider Name | VICTORIA WEEKS DESHAZO OD
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Gender | Female
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 3240 EDWARDS LAKE PKWY STE 100
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City | TRUSSVILLE
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State | AL
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Zip | 35235-3128
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Country | US
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Telephone | 205-949-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 1229 CONCORD AVE
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City | BIRMINGHAM
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State | AL
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Zip | 35213-2142
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Country | US
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Telephone | 334-248-1395
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | SF50TAD62
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License Number State | AL
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