Provider Demographics
NPI:1871344051
Name:LIFETIME VISION
Entity type:Organization
Organization Name:LIFETIME VISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIET
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:832-278-1443
Mailing Address - Street 1:4899 HIGHWAY 6 STE 101B
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-1880
Mailing Address - Country:US
Mailing Address - Phone:832-278-1443
Mailing Address - Fax:
Practice Address - Street 1:4899 HIGHWAY 6 STE 101B
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-1880
Practice Address - Country:US
Practice Address - Phone:832-278-1443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIET TRAN OD PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty