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General NPI Number Information
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NPI Number | 1811770696
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Entity Type | Organization
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Legal Business Name | BROWN EYED GIRLS PLLC
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Dates
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Enumeration Date | 08/16/2023
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 2510 BIENVILLE BLVD
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3117
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Country | US
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Telephone | 228-875-3318
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Fax | 228-875-3398
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Provider Business Mailing Address
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Address Line | 13018 DESOTO BLUFF CIR
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City | VANCLEAVE
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State | MS
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Zip | 39565-6582
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Country | US
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Telephone | 228-282-5036
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Fax | 228-875-3398
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | SHANTEL NUNEZ
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Credential | OD
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Telephone | 228-282-5036
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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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