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General NPI Number Information
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NPI Number | 1063441129
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Entity Type | Organization
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Legal Business Name | FAMILY VISION ASSOCIATES,PA
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 01/10/2014
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Provider Practice Location Address
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Address Line | 5431 EVERHART RD
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City | CORPUS CHRISTI
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State | TX
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Zip | 78411-4805
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Country | US
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Telephone | 361-854-1833
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Fax | 361-852-1210
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Provider Business Mailing Address
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Address Line | 5431 EVERHART RD
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City | CORPUS CHRISTI
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State | TX
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Zip | 78411-4805
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Country | US
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Telephone | 361-854-1833
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Fax | 361-852-1210
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN P ALLEN
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Credential | O.D.
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Telephone | 361-854-1833
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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 | 6733TG
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License Number State | TX
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