Healthcare Provider Details

I. General information

NPI: 1003326893
Provider Name (Legal Business Name): VISION TRENDS GRANDPARKWAY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2017
Last Update Date: 01/18/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6625 SPRING STUEBNER RD STE 215
SPRING TX
77389-5356
US

IV. Provider business mailing address

406 SAWDUST RD
THE WOODLANDS TX
77380-2243
US

V. Phone/Fax

Practice location:
  • Phone: 281-350-2020
  • Fax: 832-408-7631
Mailing address:
  • Phone: 281-465-9505
  • Fax: 832-408-7631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3399TG
License Number StateTX

VIII. Authorized Official

Name: VISION TRENDS
Title or Position: OWNER
Credential:
Phone: 281-363-2020