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Organization
EYE CARE SURGERY CENTER OF MEMPHIS, LLC
Active
Organization
EYE CARE SURGERY CENTER OF MEMPHIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUBBA R. GOLLAMUDI M.D. (CHAIRMAN AND MANAGER)
(901) 685-2200
Entity
Organization
Contact information
Practice address
5350 POPLAR AVE, SUITE 900, MEMPHIS, TN 38119-3699
(901) 473-8115
(901) 473-8116
Mailing address
825 RIDGE LAKE BLVD, MEMPHIS, TN 38120-9411
(901) 685-2200
(901) 255-5631
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0000000167
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03670046
—
MS
05
—
3288892
—
TN
Enumeration date
10/23/2006
Last updated
07/25/2022
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