Provider Demographics
NPI:1194058677
Name:RUDOWSKI EYECARE, PLLC
Entity type:Organization
Organization Name:RUDOWSKI EYECARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:TRANAS
Authorized Official - Last Name:RUDOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:615-462-6835
Mailing Address - Street 1:1618 LEE VICTORY PKWY
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6529
Mailing Address - Country:US
Mailing Address - Phone:615-462-6835
Mailing Address - Fax:615-462-6836
Practice Address - Street 1:1618 LEE VICTORY PKWY
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6529
Practice Address - Country:US
Practice Address - Phone:615-462-6835
Practice Address - Fax:615-462-6836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-15
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2597152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty