Organization
EYEGAZE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DIXON CLEVELAND (PRESIDENT AND CEO)
(703) 385-8800
Entity
Organization
Contact information
Practice address
10363A DEMOCRACY LN, FAIRFAX, VA 22030
(703) 385-7133
(703) 385-7137
Mailing address
10363 DEMOCRACY LN, FAIRFAX, VA 22030-2505
(703) 385-7133
(703) 385-7137
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001953189-0001
—
PA
05
—
003113149
—
CT
05
—
009908055
—
AL
05
—
0185221
—
NJ
05
—
17790000
—
ME
01
—
179619
ANTHEM BLUE CROSS BLUE SHIELD
VA
05
—
1871658609
—
CA
05
—
1871658609
—
VA
05
—
200345260A
—
IN
05
—
2411312
—
OH
05
—
4178963
—
MD
05
—
78723566
—
NM
05
—
90006974
—
KY
05
—
9053661
—
WA
05
—
9100598
—
VA
05
—
DM1330
—
SC
05
—
VLCT1986
—
MI
Enumeration date
12/22/2006
Last updated
04/24/2020
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