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General NPI Number Information
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NPI Number | 1376907121
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Entity Type | Organization
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Legal Business Name | BULVERDE VISION CENTER, PC
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Dates
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Enumeration Date | 04/07/2016
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Last Update Date | 04/07/2016
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Provider Practice Location Address
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Address Line | 121 BULVERDE CROSSING RD STE 116
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City | BULVERDE
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State | TX
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Zip | 78163-6200
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Country | US
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Telephone | 830-980-2020
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Fax | 210-495-9398
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Provider Business Mailing Address
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Address Line | 121 BULVERDE CROSSING RD STE 116
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City | BULVERDE
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State | TX
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Zip | 78163-6200
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Country | US
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Telephone | 830-980-2020
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Fax | 210-495-9398
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MONICA LINETTE ALLISON
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Credential | OD
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Telephone | 830-980-2020
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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 | 5551TG
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License Number State | TX
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