Provider Demographics
NPI: | 1235960808 |
---|---|
Name: | THE CENTER FOR VISION DEVELOPMENT, P.A. |
Entity type: | Organization |
Organization Name: | THE CENTER FOR VISION DEVELOPMENT, P.A. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OFFICE MANAGER |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | TRACIE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | STRANGE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 512-329-8900 |
Mailing Address - Street 1: | 5656 BEE CAVES RD STE D201 |
Mailing Address - Street 2: | |
Mailing Address - City: | WEST LAKE HILLS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78746-5236 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 512-329-8900 |
Mailing Address - Fax: | 512-329-8105 |
Practice Address - Street 1: | 5656 BEE CAVES RD STE D201 |
Practice Address - Street 2: | |
Practice Address - City: | WEST LAKE HILLS |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78746-5236 |
Practice Address - Country: | US |
Practice Address - Phone: | 512-329-8900 |
Practice Address - Fax: | 512-329-8105 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-08-13 |
Last Update Date: | 2024-08-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Single Specialty |