MEDICARE: VISION CARE PRO 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
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1871376517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION CARE PRO PLLC

Provider Business Mailing Address
First Line	:	9056 FREMONT TRL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-6286
Country	:	US
Telephone Number	:	806-577-7839
Fax Number	:

Provider Business Practice Location Address
First Line	:	5336 GOLDEN TRIANGLE BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-4406
Country	:	US
Telephone Number	:	806-577-7839
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. AMANDA DANETTE GONZALES
Credential	:	O.D.
Telephone Number	:	806-577-7839

Provider Enumeration Date	:	08/16/2023
Last Update Date	:	08/16/2023

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Directions to “VISION CARE PRO PLLC ” Practice Location

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