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General NPI Number Information
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NPI Number | 1396826459
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Entity Type | Organization
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Legal Business Name | PREMIER VISION SERVICES PLLC
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 3635 S SONCY RD
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City | AMARILLO
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State | TX
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Zip | 79119-6402
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Country | US
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Telephone | 806-356-6868
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Fax | 806-351-0120
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Provider Business Mailing Address
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Address Line | 3635 S SONCY RD
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City | AMARILLO
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State | TX
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Zip | 79119-6402
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Country | US
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Telephone | 806-356-6868
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Fax | 806-351-0120
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Authorized Official
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Title or Position | BILLING
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Name | SUZETTE SCOTT
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Credential |
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Telephone | 806-356-6868
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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 |
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License Number State |
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