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Contact Information

BLACK OPTOMETRIC EYE ASSOCIATES,PA
518 W JOHN ST
MATTHEWS, NC28105-5353
 Phone: 704-847-9833
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for BLACK OPTOMETRIC EYE ASSOCIATESPA · (Female)

NPI Number 1073788923
Status Active
Credentials
Entity Individual
Enumeration date 04/22/2008
Last updated 02/21/2010 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • NC License # 1176
  • NC Medicaid 8909106
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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