Provider Demographics
NPI:1134111602
Name:VISION MART INC.
Entity Type:Organization
Organization Name:VISION MART INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HALL
Authorized Official - Suffix:III
Authorized Official - Credentials:ABOC
Authorized Official - Phone:832-249-6278
Mailing Address - Street 1:12230 MARCREST CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4882
Mailing Address - Country:US
Mailing Address - Phone:832-912-1300
Mailing Address - Fax:832-912-1303
Practice Address - Street 1:12320 BARKER CYPRESS RD
Practice Address - Street 2:400
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-8325
Practice Address - Country:US
Practice Address - Phone:832-912-1300
Practice Address - Fax:832-912-1303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX024637332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5245200001Medicare ID - Type UnspecifiedPROVIDER NUMBER