Provider Demographics
NPI:1073855227
Name:VISION ETC
Entity Type:Organization
Organization Name:VISION ETC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRANG
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-485-4435
Mailing Address - Street 1:8321 BROADWAY ST STE 124
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-5770
Mailing Address - Country:US
Mailing Address - Phone:281-485-4435
Mailing Address - Fax:281-485-4033
Practice Address - Street 1:8321 BROADWAY ST STE 124
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5770
Practice Address - Country:US
Practice Address - Phone:281-485-4435
Practice Address - Fax:281-485-4033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-25
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5798T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty