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Individual

DR. AJAY SINGH MATTU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
3032 N EASTMAN RD STE 100, LONGVIEW, TX 75605-5024
(903) 663-2020
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
(571) 223-6780

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10483
TX
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
07/25/2022
Last updated
08/09/2022
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