Healthcare Provider Details

I. General information

NPI: 1750839874
Provider Name (Legal Business Name): COLTON VISION PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2016
Last Update Date: 07/20/2022
Certification Date: 08/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W FM 544 SUITE 102
MURPHY TX
75094-4200
US

IV. Provider business mailing address

601 W FM 544 STE 109
MURPHY TX
75094-4228
US

V. Phone/Fax

Practice location:
  • Phone: 972-578-2020
  • Fax: 972-476-1195
Mailing address:
  • Phone: 469-478-1364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number8439TG
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number8439TG
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number8439TG
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number8439TG
License Number StateTX

VIII. Authorized Official

Name: BRUCE ADAM COLTON
Title or Position: OWNER
Credential: OD
Phone: 972-578-2020