MEDICARE: VIRGINIA VISION ASSOCIATES OPTOMETRY PLLC

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	0618000084	VA

General Provider Information

NPI Number	:	1295826220
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRGINIA VISION ASSOCIATES OPTOMETRY PLLC

Provider Business Mailing Address
First Line	:	3800 FAIRFAX DR STE 1
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22203-1703
Country	:	US
Telephone Number	:	703-522-3454
Fax Number	:	703-522-9636

Provider Business Practice Location Address
First Line	:	3800 FAIRFAX DR STE 1
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22203-1703
Country	:	US
Telephone Number	:	703-522-3454
Fax Number	:	703-522-9636

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RUSSELL BEACH
Credential	:
Telephone Number	:	703-522-3454

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	09/29/2025

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