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General NPI Number Information
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NPI Number | 1699471888
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Entity Type | Organization
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Legal Business Name | ESSENCE VISION PLLC
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Dates
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Enumeration Date | 01/31/2023
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 39739 LBJ FWY
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City | DALLAS
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State | TX
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Zip | 75237-3560
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Country | US
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Telephone | 469-867-2677
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Fax |
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Provider Business Mailing Address
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Address Line | 3618 FERN VALLEY CT
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City | DALLAS
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State | TX
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Zip | 75287-6271
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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 | MANGER
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Name | TRANG NGUYEN
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Credential |
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Telephone | 713-614-7678
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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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