Organization
TEI-WAKE FOREST OD PLLC
Active
Other names
Heritage Eye Care, OD
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA GUEVARA (BILLING MANAGER)
(919) 648-2750
Entity
Organization
Contact information
Practice address
3211 ROGERS RD STE 100, WAKE FOREST, NC 27587-3891
(919) 453-1220
(919) 453-1221
Mailing address
742 MCKNIGHT DR STE 100, KNIGHTDALE, NC 27545-7764
(919) 266-2048
(919) 266-4648
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
12/09/2020
Last updated
01/08/2021
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