Provider Demographics
NPI:1023543113
Name:PROSPER VISION PLLC
Entity Type:Organization
Organization Name:PROSPER VISION PLLC
Other - Org Name:EYE GALLERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:214-693-8040
Mailing Address - Street 1:1170 N PRESTON RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-9031
Mailing Address - Country:US
Mailing Address - Phone:214-305-4020
Mailing Address - Fax:
Practice Address - Street 1:1170 N PRESTON RD
Practice Address - Street 2:SUITE 120
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-9031
Practice Address - Country:US
Practice Address - Phone:214-305-4020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4019TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty