MEDICARE: 20/20 VISION CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	3877	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	090753001	OTHER	TX	MEDICARE RAIL ROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00E71M	OTHER	TX	BCBS
2	110211	OTHER	TX	EYEMED
3	32713	OTHER	TX	OPTICARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184803421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	20/20 VISION CARE INC

Provider Business Mailing Address
First Line	:	1313 S 10TH ST
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78501-5023
Country	:	US
Telephone Number	:	956-630-2020
Fax Number	:	956-630-2060

Provider Business Practice Location Address
First Line	:	1313 S 10TH ST
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78501-5023
Country	:	US
Telephone Number	:	956-630-2020
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	FRED FARIAS
Credential	:	O.D.
Telephone Number	:	956-630-2020

Provider Enumeration Date	:	11/02/2007
Last Update Date	:	05/22/2008

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Directions to “20/20 VISION CARE INC ” Practice Location

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