Organization
NETRA OPTOMETRIC ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RITESH POUDYAL O.D. (PRESIDENT)
(336) 793-5904
Entity
Organization
Contact information
Practice address
3732 CREEKSHIRE CT, WINSTON SALEM, NC 27103-1363
(336) 793-5904
Mailing address
3732 CREEKSHIRE CT, WINSTON SALEM, NC 27103-1363
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2167
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5914663
—
NC
Enumeration date
10/01/2010
Last updated
11/09/2010
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