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NPI Code Detail

MEDICARE: VILLAGE VISION CENTER, PLLC

MEDICARE: VILLAGE VISION CENTER, PLLC
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 : 1841742558
Entity Type Code : Organization
Provider Name (Legal Business Name) : VILLAGE VISION CENTER, PLLC
Provider Business Mailing Address
First Line : 2300 HIGHLAND VILLAGE RD
Second Line : SUITE 200
City : HIGHLAND VILLAGE
State : TX
Zip : 75077-7191
Country : US
Telephone Number : 972-317-3888
Fax Number : 972-317-9872
Provider Business Practice Location Address
First Line : 2300 HIGHLAND VILLAGE RD
Second Line : SUITE 200
City : HIGHLAND VILLAGE
State : TX
Zip : 75077-7191
Country : US
Telephone Number : 972-317-3888
Fax Number : 972-317-9872
Authorized Official
Title or Position : OWNER
Name : DR. ANISHA JACOB
Credential : OD
Telephone Number : 708-696-3218
Provider Enumeration Date : 10/28/2016
Last Update Date : 10/28/2016

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Directions to “VILLAGE VISION CENTER, PLLC ” Practice Location

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