Provider Demographics
NPI:1083761332
Name:IN VISION EYE CARE, L.L.C.
Entity Type:Organization
Organization Name:IN VISION EYE CARE, L.L.C.
Other - Org Name:BOA VISION CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-247-0636
Mailing Address - Street 1:2924 S 31ST ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-1861
Mailing Address - Country:US
Mailing Address - Phone:254-247-0636
Mailing Address - Fax:254-247-0634
Practice Address - Street 1:404 UNIVERSITY DR E
Practice Address - Street 2:SUITE B
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-5905
Practice Address - Country:US
Practice Address - Phone:979-693-2891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139949513Medicaid
TX21189OtherHMO
TX21189OtherHMO