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General NPI Number Information
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NPI Number | 1093083636
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Entity Type | Organization
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Legal Business Name | US VISION GROUP LLC
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Dates
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Enumeration Date | 12/10/2011
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Last Update Date | 12/10/2011
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Provider Practice Location Address
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Address Line | 1515 N TOWN EAST BLVD SUITE 523B
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City | MESQUITE
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State | TX
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Zip | 75150-4157
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Country | US
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Telephone | 972-638-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 N TOWN EAST BLVD SUITE 523B
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City | MESQUITE
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State | TX
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Zip | 75150-4157
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Country | US
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Telephone | 972-638-8600
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TASNEEM MAMDANI
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Credential | O.D.
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Telephone | 505-232-2020
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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 | 7845T
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License Number State | TX
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