Basic Information
| Provider Information | |||||||||
| NPI: | 1184721565 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EYE PHYSICIANS OPTICAL LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7000 STONEWOOD DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | WEXFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150907376 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249404086 | ||||||||
| FaxNumber: | 7249404091 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 DELAFIELD RD | ||||||||
| Address2: | SUITE 2020 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152153205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4127841330 | ||||||||
| FaxNumber: | 4127840203 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 01/04/2017 | ||||||||
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| AuthorizedOfficialLastName: | BALOURIS | ||||||||
| AuthorizedOfficialFirstName: | CHRIST | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 7249404001 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.