Provider Demographics
NPI:1144005380
Name:AVAKS OPTOMETRY
Entity type:Organization
Organization Name:AVAKS OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SERGE
Authorized Official - Middle Name:G
Authorized Official - Last Name:AVAK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:708-308-8892
Mailing Address - Street 1:1320 BURMAN DR
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-9275
Mailing Address - Country:US
Mailing Address - Phone:708-308-8892
Mailing Address - Fax:
Practice Address - Street 1:3000 COUNTRYSIDE DR
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-8402
Practice Address - Country:US
Practice Address - Phone:209-216-4042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty