Provider Demographics
NPI:1528472099
Name:DR. SOPHEAR SENG, LLC
Entity type:Organization
Organization Name:DR. SOPHEAR SENG, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOPHEAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-225-5580
Mailing Address - Street 1:2700 S SHACKLEFORD RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6918
Mailing Address - Country:US
Mailing Address - Phone:501-225-5580
Mailing Address - Fax:501-225-5582
Practice Address - Street 1:2700 S SHACKLEFORD RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6918
Practice Address - Country:US
Practice Address - Phone:501-225-5580
Practice Address - Fax:501-225-5582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2699152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty