# SUMMIT EYE CARE SURGERY CENTER, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467060327
- **Authorized official:** VICKAS KHEMSARA MD (CEO)
- **Authorized official phone:** (336) 765-0910

## Contact information

- **Practice address:** 3073 TRENWEST DR, WINSTON SALEM, NC 27103-3207
- **Practice address phone:** (336) 765-0960
- **Practice address fax:** (336) 765-7453
- **Mailing address:** 3073 TRENWEST DR, WINSTON SALEM, NC 27103-3207
- **Mailing address phone:** (336) 765-0960
- **Mailing address fax:** (336) 765-7453

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |
| 261QS0132X | Ophthalmologic Surgery Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 07/16/2020
- **Last updated:** 07/16/2020