MEDICARE: VISION TECH OPTICAL

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	156FC0800X	Contact Lens Technician/Technologist	CP00754	TX
2	156FX1800X	Optician		TX
3	332H00000X	Eyewear Supplier		TX

General Provider Information

NPI Number	:	1285667725
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION TECH OPTICAL

Provider Business Mailing Address
First Line	:	2310 N. EXPRESSWAY
Second Line	:	SUITE G
City	:	BROWNSVILLE
State	:	TX
Zip	:	78521
Country	:	US
Telephone Number	:	956-547-9500
Fax Number	:	956-547-9500

Provider Business Practice Location Address
First Line	:	2310 N EXPRESSWAY
Second Line	:	SUITE G
City	:	BROWNSVILLE
State	:	TX
Zip	:	78521-0903
Country	:	US
Telephone Number	:	956-547-9500
Fax Number	:	956-547-9500

Authorized Official
Title or Position	:	OWNER
Name	:	MR. FREDRICK RAYMOND GREENWOOD
Credential	:
Telephone Number	:	956-547-9500

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	02/10/2017

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Directions to “VISION TECH OPTICAL ” Practice Location

Language	Start Address	Practice Location

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