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General NPI Number Information
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NPI Number | 1740582469
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Entity Type | Organization
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Legal Business Name | LA FERIA VISION CENTER, PA
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Dates
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Enumeration Date | 12/01/2010
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Last Update Date | 05/12/2011
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Provider Practice Location Address
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Address Line | 601 E EXPRESSWAY 83 SUITE 100B
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City | WESLACO
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State | TX
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Zip | 78596
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Country | US
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Telephone | 956-969-2816
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Fax | 956-968-6956
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Provider Business Mailing Address
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Address Line | 601 E EXPRESSWAY 83 SUITE 100B
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City | WESLACO
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State | TX
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Zip | 78596
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Country | US
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Telephone | 956-969-2816
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Fax | 956-968-6956
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | CELINA VILLANUEVA
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Credential |
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Telephone | 956-245-2518
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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 | 6422TG
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License Number State | TX
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