MEDICARE: HEATHER MICHELLE BEACH ALLEN LDO, ABOC, NCLEC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician	1834	NC

General Provider Information

NPI Number	:	1245416528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER MICHELLE BEACH ALLEN LDO, ABOC, NCLEC

Provider Business Mailing Address
First Line	:	209 S FUQUAY AVE STE 120
Second Line	:
City	:	FUQUAY VARINA
State	:	NC
Zip	:	27526-2254
Country	:	US
Telephone Number	:	919-567-0059
Fax Number	:	919-567-0079

Provider Business Practice Location Address
First Line	:	209 S FUQUAY AVE STE 120
Second Line	:
City	:	FUQUAY VARINA
State	:	NC
Zip	:	27526-2254
Country	:	US
Telephone Number	:	919-567-0059
Fax Number	:	919-567-0079

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2008
Last Update Date	:	12/01/2025

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