Provider Demographics
NPI:1841249703
Name:HORA, SYLVESTER WILLIAM (OD)
Entity type:Individual
Prefix:
First Name:SYLVESTER
Middle Name:WILLIAM
Last Name:HORA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2295 HIGHWAY 196 S
Mailing Address - Street 2:
Mailing Address - City:PIPERTON
Mailing Address - State:TN
Mailing Address - Zip Code:38017-5733
Mailing Address - Country:US
Mailing Address - Phone:901-486-5211
Mailing Address - Fax:
Practice Address - Street 1:155 N MAIN ST
Practice Address - Street 2:STE 101B
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-2650
Practice Address - Country:US
Practice Address - Phone:901-853-1420
Practice Address - Fax:901-853-1421
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNODT000810152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3594782Medicaid
TN3594782Medicare PIN
TN3594782Medicaid
TNT61208Medicare UPIN