Individual
DR. THEODORA VROUSTOURIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OOD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618 000576
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2119694
AETNA-HMO
VA
01
—
277700
ALLIANCE,MDIPA,MAMSI,OPC
VA
01
—
286010
ANTHEM-CC
VA
01
—
286011
ANTHEM-LP
VA
01
—
5675449
AETNA-PPO
VA
05
—
9231676
—
VA
01
—
9314-0006
BCBS-CAREFIRST
VA
Enumeration date
10/16/2006
Last updated
07/09/2007
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