Healthcare Provider Details

I. General information

NPI: 1740238583
Provider Name (Legal Business Name): VISION PSYCHOLOGICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 HIGHWAY 365 SUITE 620
NEDERLAND TX
77627-6256
US

IV. Provider business mailing address

2300 HIGHWAY 365 SUITE 620
NEDERLAND TX
77627-6256
US

V. Phone/Fax

Practice location:
  • Phone: 409-729-0400
  • Fax: 866-573-8008
Mailing address:
  • Phone: 409-729-0400
  • Fax: 866-573-8008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: CURTIS E WILLS II
Title or Position: PRESIDENT/CEO
Credential: EDD
Phone: 409-729-0400