Healthcare Provider Details

I. General information

NPI: 1366312456
Provider Name (Legal Business Name): VERDANT VISION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 HIGDON FERRY RD STE E
HOT SPRINGS AR
71913-6904
US

IV. Provider business mailing address

1635 HIGDON FERRY RD STE E
HOT SPRINGS AR
71913-6904
US

V. Phone/Fax

Practice location:
  • Phone: 501-525-4272
  • Fax:
Mailing address:
  • Phone: 870-219-5862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. TRAVIS BAILEY
Title or Position: OPTOMETRIST/OWNER
Credential: OD
Phone: 870-219-5862