Healthcare Provider Details

I. General information

NPI: 1407074214
Provider Name (Legal Business Name): VISION PARK FAMILY EYE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2699 86TH ST
URBANDALE IA
50322-4309
US

IV. Provider business mailing address

475 S 50TH ST SUITE 300
WEST DES MOINES IA
50265-6981
US

V. Phone/Fax

Practice location:
  • Phone: 515-270-2490
  • Fax: 515-270-2494
Mailing address:
  • Phone: 515-225-8667
  • Fax: 515-270-2494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: MELISSA BILLINGS
Title or Position: OD, PARTNER
Credential:
Phone: 515-270-2490