Provider Demographics
NPI:1588224281
Name:TAWFIK, LAILA (OD)
Entity type:Individual
Prefix:
First Name:LAILA
Middle Name:
Last Name:TAWFIK
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 1:520 RIVERGATE PKWY
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-2030
Mailing Address - Country:US
Mailing Address - Phone:706-546-0170
Mailing Address - Fax:
Practice Address - Street 1:211 DUKE ST UNIT A
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-4503
Practice Address - Country:US
Practice Address - Phone:718-960-2041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003281152W00000X
NY008964152W00000X
TN3877152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist