MEDICARE: VISION ESSENCE 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		TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0077FF	OTHER	TX	BLUE CROSS BLUE SHILED
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396763157
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION ESSENCE INC.

Provider Business Mailing Address
First Line	:	PO BOX 710586
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77271-0586
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7586 W BELLFORT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77071-2102
Country	:	US
Telephone Number	:	713-773-4700
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	IKAEHOTA NYOWHEOMA
Credential	:
Telephone Number	:	713-773-4700

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	07/21/2022

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Directions to “VISION ESSENCE INC. ” Practice Location

Language	Start Address	Practice Location

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