Healthcare Provider Details

I. General information

NPI: 1871713685
Provider Name (Legal Business Name): VECD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 02/14/2022
Certification Date: 02/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6510 ABRAMS RD SUITE 150
DALLAS TX
75231-7217
US

IV. Provider business mailing address

6510 ABRAMS RD SUITE 150
DALLAS TX
75231-7217
US

V. Phone/Fax

Practice location:
  • Phone: 214-341-4799
  • Fax: 214-341-0623
Mailing address:
  • Phone: 214-341-4799
  • Fax: 214-341-0623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number5054TG
License Number StateTX

VIII. Authorized Official

Name: TODD FRANK MILLER
Title or Position: OWNER
Credential:
Phone: 214-341-4799