Provider Demographics
NPI:1871535294
Name:VISION TRENDS - WOODLANDS PA
Entity type:Organization
Organization Name:VISION TRENDS - WOODLANDS PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VISION
Authorized Official - Middle Name:
Authorized Official - Last Name:TRENDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-363-2020
Mailing Address - Street 1:402 SAWDUST RD
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2243
Mailing Address - Country:US
Mailing Address - Phone:281-363-2020
Mailing Address - Fax:
Practice Address - Street 1:402 SAWDUST RD
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-2243
Practice Address - Country:US
Practice Address - Phone:281-363-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX019285801Medicaid
TX00E26MOtherPTAN
TX0993410001Medicare NSC
TX00E26MOtherPTAN
TX8B5473Medicare PIN
TX0A5931Medicare PIN
TX019285801Medicaid
TX8L21682Medicare PIN
TX8K1667Medicare PIN
TX8L17559Medicare PIN
TX8L2154Medicare PIN
TX80941EMedicare PIN
TX8B5606Medicare PIN
TX8L17558Medicare PIN
TX8L20738Medicare PIN