Provider Demographics
NPI:1811770696
Name:BROWN EYED GIRLS PLLC
Entity type:Organization
Organization Name:BROWN EYED GIRLS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANTEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:228-282-5036
Mailing Address - Street 1:13018 DESOTO BLUFF CIR
Mailing Address - Street 2:
Mailing Address - City:VANCLEAVE
Mailing Address - State:MS
Mailing Address - Zip Code:39565-6582
Mailing Address - Country:US
Mailing Address - Phone:228-282-5036
Mailing Address - Fax:228-875-3398
Practice Address - Street 1:2510 BIENVILLE BLVD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3117
Practice Address - Country:US
Practice Address - Phone:228-875-3318
Practice Address - Fax:228-875-3398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty