Healthcare Provider Details

I. General information

NPI: 1396311643
Provider Name (Legal Business Name): HEWITT VISION, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2021
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 N HEWITT DR
HEWITT TX
76643-3038
US

IV. Provider business mailing address

502 N HEWITT DR
HEWITT TX
76643-3038
US

V. Phone/Fax

Practice location:
  • Phone: 254-666-2992
  • Fax:
Mailing address:
  • Phone: 254-666-2292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CLAYTON RUTKOWSKI
Title or Position: SHAREHOLDER
Credential: OD
Phone: 979-966-8847