MEDICARE: DR. VALERIE S URBAN OPTOMETRIST

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	152W00000X	Optometrist	1300	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265413587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VALERIE S URBAN OPTOMETRIST

Provider Business Mailing Address
First Line	:	PO BOX 51096
Second Line	:
City	:	PIEDMONT
State	:	SC
Zip	:	29673-2096
Country	:	US
Telephone Number	:	864-295-3550
Fax Number	:	864-295-3242

Provider Business Practice Location Address
First Line	:	3529 HIGHWAY 153
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29611-7515
Country	:	US
Telephone Number	:	864-295-3550
Fax Number	:	864-295-3242

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

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	07/14/2023

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