Provider Demographics
NPI:1902351588
Name:GARCIA, MELODY (OD)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5185 PEACHTREE PKWY STE 350
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-6545
Mailing Address - Country:US
Mailing Address - Phone:770-850-5437
Mailing Address - Fax:770-796-0298
Practice Address - Street 1:5185 PEACHTREE PKWY STE 350
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-6545
Practice Address - Country:US
Practice Address - Phone:770-850-5437
Practice Address - Fax:770-796-0298
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV008436152W00000X, 207WX0110X
GAOPT3307152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist