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General NPI Number Information
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NPI Number | 1366628646
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Entity Type | Organization
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Legal Business Name | SANVISION PC
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 01/16/2008
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Provider Practice Location Address
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Address Line | 12334 GULF FWY STE A
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City | HOUSTON
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State | TX
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Zip | 77034-6502
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Country | US
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Telephone | 713-941-1082
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Fax | 713-941-2819
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Provider Business Mailing Address
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Address Line | 12334 GULF FWY
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City | HOUSTON
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State | TX
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Zip | 77034-4671
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Country | US
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Telephone | 713-941-1082
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Fax | 713-941-2819
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Authorized Official
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Title or Position | OWNER
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Name | DR. LUDIAMMA JOHN
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Credential | OPTOMETRIST
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Telephone | 713-941-1082
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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 | 5619
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License Number State | TX
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