Provider Demographics
NPI:1871704775
Name:VISION PRO, P.A.
Entity type:Organization
Organization Name:VISION PRO, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:PROSKE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-353-3937
Mailing Address - Street 1:20920 KUYKENDAHL RD
Mailing Address - Street 2:STE C
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3378
Mailing Address - Country:US
Mailing Address - Phone:281-353-3937
Mailing Address - Fax:281-528-9451
Practice Address - Street 1:20920 KUYKENDAHL RD.
Practice Address - Street 2:STE. C
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379
Practice Address - Country:US
Practice Address - Phone:281-353-3937
Practice Address - Fax:281-528-9451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05881TG152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208606801Medicaid
TXU89666Medicare UPIN