Organization
PLAXICO EYE CARE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT E. PLAXICO O.D. (OPTOMETRIST)
(803) 714-1116
Entity
Organization
Contact information
Practice address
749B UNIVERSITY VILLAGE DR, BLYTHEWOOD, SC 29016-7613
(803) 714-1116
(803) 714-1116
Mailing address
135I BLYTHEWOOD RD, BLYTHEWOOD, SC 29016-8426
(803) 714-1116
(803) 714-1116
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1412
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D14125
—
SC
Enumeration date
08/18/2009
Last updated
12/05/2012
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