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General NPI Number Information
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NPI Number | 1720786775
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Entity Type | Organization
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Legal Business Name | LOW VISION INSTITUTE OF TEXAS PLLC
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 4020 W PLANO PKWY
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City | PLANO
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State | TX
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Zip | 75093-5613
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Country | US
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Telephone | 469-999-2747
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Fax | 469-606-0925
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Provider Business Mailing Address
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Address Line | 4020 W PLANO PKWY
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City | PLANO
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State | TX
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Zip | 75093-5613
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Country | US
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Telephone | 469-999-2747
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Fax | 469-606-0925
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Authorized Official
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Title or Position | OWNER
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Name | LAUREN JOE BAILEY
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Credential | OD
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Telephone | 469-999-2747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WS0006X
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Taxonomy Name | Sports Vision 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 | 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 #3
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number |
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License Number State |
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