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General NPI Number Information
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NPI Number | 1528175171
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Entity Type | Organization
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Legal Business Name | HENDRIX VISION CENTER INC
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 11685 BASELTON AVENUE
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City | PHILADELPHIA
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State | PA
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Zip | 19149
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Country | US
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Telephone | 917-449-5033
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Fax |
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Provider Business Mailing Address
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Address Line | 11685 BUSTLETON AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19116
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Country | US
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Telephone | 215-698-8980
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Fax | 215-698-8986
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | GALINA KOVAL
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Credential |
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Telephone | 215-698-8980
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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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