Lifetime Eye Care C. Houston Teaters, OD, PC

Key facts

NPI: 1487976072
Entity type: Organization (NPI type 2)
Primary specialty: Optometrist 152W00000X
License: 0618000913 (VA)
Legal business name: LIFETIME EYE CARE C. HOUSTON TEATERS, OD, PC
Practice address: 2851 Carrollton Pike
Suite a
Woodlawn, VA 24381
Phone: (276) 236-0400
NPI assigned: Feb 23, 2010
Organization subpart: No

Authorized official

Name: Dr. Charles H Teaters, OD
Title: President
Phone: (540) 392-9020

National Provider Directory

Locations

2851 Carrollton Pike
Ste A1
Woodlawn, VA 24381
Phone (276) 236-0400

2851 Carrollton Pike
Ste A
Woodlawn, VA 24381
Phone (276) 236-0400

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Optometrist Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP	152W00000X	0618000913	VA	Yes

Addresses

Primary practice location

2851 Carrollton Pike
Suite a
Woodlawn, VA 24381

Mailing address

615 Dee Dee Drive
Christiansburg, VA 24073
Phone (540) 392-9020

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 23, 2010.

{
    "created_epoch": "1266883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266883200000",
    "number": "1487976072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 DEE DEE DRIVE",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "24073",
            "telephone_number": "540-392-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2851 CARROLLTON PIKE",
            "address_2": "SUITE A",
            "city": "WOODLAWN",
            "state": "VA",
            "postal_code": "24381",
            "telephone_number": "276-236-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME EYE CARE C. HOUSTON TEATERS, OD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-23",
        "last_updated": "2010-02-23",
        "status": "A",
        "authorized_official_last_name": "TEATERS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-392-9020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodlawn, VA

All providers in Woodlawn, VA · Optometrist in Virginia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2010. 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.

Verify at the official NPI Registry.