Provider Demographics
NPI:1376957530
Name:VARAKALAYIL, ASHLEY (OD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:VARAKALAYIL
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 1:259 BENWICK DR
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-3256
Mailing Address - Country:US
Mailing Address - Phone:630-408-1805
Mailing Address - Fax:
Practice Address - Street 1:6850 N SHILOH RD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-2912
Practice Address - Country:US
Practice Address - Phone:972-414-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.010808152W00000X
TX8538T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist