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NPI Code Detail

MEDICARE: EYE CLARITY VISION ASSOCIATES, PLLC

MEDICARE: EYE CLARITY VISION ASSOCIATES, PLLC
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
1152WC0802XCorneal and Contact Management Optometrist7446TGTX
2152WP0200XPediatric Optometrist7446TGTX
3152WS0006XSports Vision Optometrist7446TGTX
4152W00000XOptometrist7446TGTX

General Provider Information

NPI Number : 1629386354
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYE CLARITY VISION ASSOCIATES, PLLC
Provider Business Mailing Address
First Line : 6046 FM 2920 RD
Second Line : #311
City : SPRING
State : TX
Zip : 77379-2542
Country : US
Telephone Number : 979-695-3937
Fax Number :
Provider Business Practice Location Address
First Line : 1815 BROTHERS BLVD
Second Line :
City : COLLEGE STATION
State : TX
Zip : 77845-5413
Country : US
Telephone Number : 979-695-3937
Fax Number :
Authorized Official
Title or Position : OPTOMETRISTS/OWNER
Name : DR. KRISHAN PATEL
Credential : O.D.
Telephone Number : 979-695-3937
Provider Enumeration Date : 09/15/2010
Last Update Date : 11/18/2010

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