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General NPI Number Information
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NPI Number | 1033481536
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Entity Type | Organization
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Legal Business Name | REVOLUTION EYES PLLC
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Dates
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Enumeration Date | 01/31/2012
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Last Update Date | 08/28/2013
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Provider Practice Location Address
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Address Line | 27110 CINCO RANCH BLVD. STE. 400
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City | KATY
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State | TX
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Zip | 77494
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Country | US
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Telephone | 281-394-5222
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Fax | 281-394-5232
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Provider Business Mailing Address
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Address Line | 27110 CINCO RANCH BLVD. STE. 400
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City | KATY
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State | TX
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Zip | 77494
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Country | US
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Telephone | 281-394-5222
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Fax | 281-394-5232
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. VI YEN NGUYEN
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Credential | O.D.
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Telephone | 281-394-5222
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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 | 7415TG
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License Number State | TX
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