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NPI Code Detail

MEDICARE: ARLINGTON VISION SOURCE PC

MEDICARE: ARLINGTON VISION SOURCE PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist

General Provider Information

NPI Number : 1740773795
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARLINGTON VISION SOURCE PC
Provider Business Mailing Address
First Line : 1334 E PIONEER PKWY
Second Line :
City : ARLINGTON
State : TX
Zip : 76010-6411
Country : US
Telephone Number : 817-461-4453
Fax Number : 832-934-1161
Provider Business Practice Location Address
First Line : 1334 E PIONEER PKWY
Second Line :
City : ARLINGTON
State : TX
Zip : 76010-6411
Country : US
Telephone Number : 817-461-4453
Fax Number : 832-934-1161
Authorized Official
Title or Position : OWNER/OD
Name : ISAAC S SCHUNK
Credential : OD
Telephone Number : 817-461-4453
Provider Enumeration Date : 06/13/2018
Last Update Date : 06/13/2018

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Directions to “ARLINGTON VISION SOURCE PC ” Practice Location

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