Healthcare Provider Details

I. General information

NPI: 1225494065
Provider Name (Legal Business Name): VISION ENHANCEMENT CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 NE LOOP 410 SUITE 140
SAN ANTONIO TX
78216
US

IV. Provider business mailing address

4501 MCCULLOUGH AVE SUITE 101
SAN ANTONIO TX
78212
US

V. Phone/Fax

Practice location:
  • Phone: 210-822-0900
  • Fax: 210-340-3841
Mailing address:
  • Phone: 210-822-0900
  • Fax: 210-822-1299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number5899TG
License Number StateTX

VIII. Authorized Official

Name: JASON DEVINEY
Title or Position: PRESIDENT
Credential: OD
Phone: 210-822-0900