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General NPI Number Information
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NPI Number | 1740954742
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Entity Type | Organization
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Legal Business Name | EYE & LENS LLC
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 1307 EBENEZER RD
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City | ROCK HILL
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State | SC
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Zip | 29732-2336
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Country | US
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Telephone | 803-324-3979
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Fax | 803-324-3925
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Provider Business Mailing Address
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Address Line | 1307 EBENEZER RD
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City | ROCK HILL
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State | SC
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Zip | 29732-2336
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Country | US
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Telephone | 803-324-3979
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Fax | 803-324-3925
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Authorized Official
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Title or Position | SINGLE MEMBER
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Name | DR. NIKHIL BANSAL
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Credential | OD
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Telephone | 803-324-3979
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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 |
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License Number State |
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