Healthcare Provider Details

I. General information

NPI: 1568131936
Provider Name (Legal Business Name): CLEAR VISION PEDIATRIC OPHTHALMOLOGY CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 11/11/2021
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4707 EVERHART RD STE 108
CORPUS CHRISTI TX
78411-2751
US

IV. Provider business mailing address

4707 EVERHART RD STE 108
CORPUS CHRISTI TX
78411-2751
US

V. Phone/Fax

Practice location:
  • Phone: 361-857-6600
  • Fax:
Mailing address:
  • Phone: 361-857-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLOTTE M AKOR
Title or Position: MD
Credential: MD
Phone: 325-261-3131