Healthcare Provider Details

I. General information

NPI: 1669160644
Provider Name (Legal Business Name): MODERN VUE EYECARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2023
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 COIT RD
PLANO TX
75075-7509
US

IV. Provider business mailing address

565 COIT RD SUITE 650
PLANO TX
75075
US

V. Phone/Fax

Practice location:
  • Phone: 972-754-5859
  • Fax:
Mailing address:
  • Phone: 214-305-9395
  • Fax: 214-305-8331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. DEBORAH NGUYEN WEI
Title or Position: THERAPEUTIC OPTOMETRIST/PART OWNER
Credential: OD
Phone: 972-754-5859