Organization
CARY EYE CENTER OPTOMETRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN LICATA DURHAM OD (OPTOMETRIST)
(919) 467-3238
Entity
Organization
Contact information
Practice address
1398 KILDAIRE FARM RD, SUITE 100, CARY, NC 27511-5567
(919) 467-3238
(919) 460-7776
Mailing address
1398 KILDAIRE FARM RD, SUITE 100, CARY, NC 27511-5567
(919) 467-3238
(919) 460-7776
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
1335
NC
152WL0500X
Low Vision Rehabilitation Optometrist
1335
NC
152WP0200X
Pediatric Optometrist
1335
NC
152WS0006X
Sports Vision Optometrist
1335
NC
152WV0400X
Vision Therapy Optometrist
Primary
1335
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
083568695
TRICARE
NC
01
—
0917N
BLUE CROSS BLUE SHIELD
NC
01
—
2253547
UNITED HEALTH CARE
NC
01
—
410036278
RAILROAD MEDICARE
NC
01
—
543199
MAMSI
NC
01
—
5910
AVESIS
NC
05
—
890971N
—
NC
01
—
B729
PARTNERS
NC
01
—
NC9335
VBA
NC
Enumeration date
02/08/2007
Last updated
11/22/2013
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