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General NPI Number Information
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NPI Number | 1003387556
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Entity Type | Organization
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Legal Business Name | VISION PERFORMANCE INSTITUTE, LLC
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Dates
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Enumeration Date | 12/10/2018
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Last Update Date | 12/10/2018
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Provider Practice Location Address
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Address Line | 3917 E STAN SCHLUETER LOOP
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City | KILLEEN
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State | TX
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Zip | 76542-4656
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Country | US
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Telephone | 254-781-0101
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Fax | 254-781-0338
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Provider Business Mailing Address
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Address Line | 3917 E STAN SCHLUETER LOOP
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City | KILLEEN
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State | TX
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Zip | 76542-4656
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | MARY BECK
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Credential | OD
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Telephone | 254-781-0101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 152WS0006X
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Taxonomy Name | Sports Vision Optometrist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 152WX0102X
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Taxonomy Name | Occupational Vision Optometrist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number |
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License Number State |
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