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General NPI Number Information
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NPI Number | 1871006965
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Entity Type | Organization
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Legal Business Name | MANOR VISION PLLC
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Dates
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Enumeration Date | 11/10/2017
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 11300 US HIGHWAY 290 E STE 220
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City | MANOR
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State | TX
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Zip | 78653-0397
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Country | US
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Telephone | 512-778-2015
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Fax | 512-778-2014
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Provider Business Mailing Address
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Address Line | 11300 US HIGHWAY 290 E STE 220
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City | MANOR
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State | TX
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Zip | 78653-0397
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Country | US
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Telephone | 512-778-2015
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Fax | 512-778-2014
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Authorized Official
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Title or Position | PRESIDENT
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Name | JILL LIU
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Credential |
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Telephone | 281-408-2020
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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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