=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942518881
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ESSILOR VISION FOUNDATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2010
-----------------------------------------------------
Last Update Date | 06/15/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13515 N STEMMONS FWY
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75234-5765
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-749-7507
-----------------------------------------------------
Fax | 972-243-3451
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13515 N STEMMONS FWY
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75234-5765
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-749-7507
-----------------------------------------------------
Fax | 972-243-3451
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | KIM SCHUY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 214-496-4056
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------