| NPI | 1568956563 |
|---|---|
| Other Name | SOUTHSIDE EYECARE, LLC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AK 144582) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 33946TLG) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2025-03-11 |