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General NPI Number Information
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NPI Number | 1245494640
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Entity Type | Organization
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Legal Business Name | BELLA VISION PLLC.
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Dates
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Enumeration Date | 07/15/2008
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Last Update Date | 06/06/2016
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Provider Practice Location Address
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Address Line | 1206 WEST 38TH STREET 1204A
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City | AUSTIN
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State | TX
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Zip | 78705-1018
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Country | US
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Telephone | 512-454-1900
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Fax | 512-206-4402
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Provider Business Mailing Address
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Address Line | 1206 WEST 38TH STREET 1204A
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City | AUSTIN
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State | TX
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Zip | 78705-1018
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Country | US
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Telephone | 512-454-1900
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Fax | 512-206-4402
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Authorized Official
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Title or Position | OWNER
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Name | DR. THI TRUONG LE
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Credential | OD
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Telephone | 512-454-1900
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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 | 00682T
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License Number State | TX
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