Lazina Choudhry, OD
Individual provider Active NPI Optometrist · Loganville, GA
NPI 1396560124 · NPPES record last updated Nov 18, 2024
Key facts
- NPI
- 1396560124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OPT003631 (GA)
- Practice address
- 4060 Atlanta Hwy Ste 1208
Loganville, GA 30052-2436 - Phone
- (470) 415-5310
- NPI assigned
- Nov 18, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT003631 | GA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| National Vision Inc | Optometrist | Current |
Accepting new patients |
Locations
4060 Atlanta Hwy
Ste 1208
Loganville, GA 30052
Phone (470) 415-5310
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT003631 | GA | Yes |
Addresses
Primary practice location
4060 Atlanta Hwy Ste 1208
Loganville, GA 30052-2436
Mailing address
4060 Atlanta Hwy Ste 1208
Loganville, GA 30052-2436
Other providers in Loganville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.