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General NPI Number Information
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NPI Number | 1356851653
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Entity Type | Organization
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Legal Business Name | BELLAIRE VISION PLLC
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Dates
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Enumeration Date | 10/02/2017
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Last Update Date | 10/02/2017
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Provider Practice Location Address
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Address Line | 4710 BELLAIRE BLVD STE 160
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City | BELLAIRE
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State | TX
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Zip | 77401-4521
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Country | US
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Telephone | 713-664-6565
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Fax | 713-664-9633
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Provider Business Mailing Address
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Address Line | 4710 BELLAIRE BLVD STE 160
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City | BELLAIRE
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State | TX
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Zip | 77401-4521
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Country | US
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Telephone | 713-664-6565
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Fax | 713-664-9633
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. STACY MICHELLE SONIK
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Credential | OD
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Telephone | 713-664-6565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 5278TG
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License Number State | TX
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