Provider Demographics
NPI:1285764589
Name:VIRGINIA EYECARE ASSOCIATES PC
Entity type:Organization
Organization Name:VIRGINIA EYECARE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOZEE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:804-526-4261
Mailing Address - Street 1:8056 PEBBLE PATH PKWY
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111
Mailing Address - Country:US
Mailing Address - Phone:804-559-1063
Mailing Address - Fax:
Practice Address - Street 1:723 SOUTHPARK BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834
Practice Address - Country:US
Practice Address - Phone:804-559-1063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000508152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty