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General NPI Number Information
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NPI Number | 1821537747
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Entity Type | Organization
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Legal Business Name | VISIONCARE GROUP AT WEST 7TH, P.A.
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Dates
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Enumeration Date | 02/13/2017
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Last Update Date | 05/02/2017
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Provider Practice Location Address
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Address Line | 3017 W 7TH ST SUITE 210
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City | FORT WORTH
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State | TX
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Zip | 76107-2223
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Country | US
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Telephone | 817-346-7077
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Fax | 817-346-6998
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Provider Business Mailing Address
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Address Line | 3017 W 7TH ST SUITE 210
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City | FORT WORTH
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State | TX
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Zip | 76107-2223
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Country | US
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Telephone | 817-346-7077
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Fax | 817-346-6998
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Authorized Official
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Title or Position | OWNER
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Name | LENA CHU
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Credential | O.D.
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Telephone | 817-346-7077
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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 | 3413TG
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License Number State | TX
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