Vantage Vision P.c.

NPI 1194859769 - Optometrist - 152W00000X

NPI Details
NPI 1194859769
Enumeration Date 03/15/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name DAT DAT
Position PRESIDENT
Phone (903) 581-2426
Fax
Practice Location
4601 S BROADWAY AVE
F22
TYLER TX, 75703-1307, US
Phone (903) 581-2426
Fax
Business Location
4601 S BROADWAY AVE
F22
TYLER TX, 75703-1307, US
Phone (903) 581-2426
Fax
Toxanomy
Taxonomy Code 152W00000X
License State Texas
License Number 6516 T
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According to our database, Vantage Vision P.c. NPI is 1194859769, taxonomy code is 152W00000X and license number is 6516 T, license state is located at Texas. Vantage Vision P.c. physically located at 4601 S Broadway Ave, Tyler TX, 75703-1307. NPI Number 1033115704 has the healthcare provider type.

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1194859769 NPI number is provided on an as is basis without warranty of any kind. 1194859769 is maintained by the National Plan & Provider Enumeration System. The contents of Vantage Vision P.c. are for informational purposes only.