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General NPI Number Information
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NPI Number | 1558629584
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Entity Type | Organization
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Legal Business Name | VISIO EYECARE INC
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Dates
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Enumeration Date | 04/27/2012
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Last Update Date | 01/11/2026
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Provider Practice Location Address
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Address Line | 1149 S 11TH ST FL 1
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City | PHILADELPHIA
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State | PA
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Zip | 19147-4624
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Country | US
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Telephone | 215-218-3200
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Fax | 215-218-3201
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Provider Business Mailing Address
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Address Line | 1149 S 11TH ST FL 1
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City | PHILADELPHIA
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State | PA
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Zip | 19147-4624
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | NGOC AU
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Credential |
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Telephone | 267-471-6245
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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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Taxonomy #2
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 4101203
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License Number State | PA
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