Provider Demographics
NPI:1740167378
Name:DESHAZO, VICTORIA WEEKS (OD)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:WEEKS
Last Name:DESHAZO
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 1:1229 CONCORD AVE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-2142
Mailing Address - Country:US
Mailing Address - Phone:334-248-1395
Mailing Address - Fax:
Practice Address - Street 1:3240 EDWARDS LAKE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35235-3128
Practice Address - Country:US
Practice Address - Phone:205-949-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALSF50TAD62152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist