Provider Demographics
NPI:1427611029
Name:FEE, NICOLE TERESA SACHIKO (OD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:TERESA SACHIKO
Last Name:FEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:2600 HARWOOD RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-3700
Practice Address - Country:US
Practice Address - Phone:817-571-6688
Practice Address - Fax:817-571-6906
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10083152W00000X
HIOD-905152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist