Provider Demographics
NPI:1144757675
Name:JESUS VISION LLC
Entity Type:Organization
Organization Name:JESUS VISION LLC
Other - Org Name:TEXAS EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:BEREKET
Authorized Official - Middle Name:HAILEAB
Authorized Official - Last Name:TSEGAI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:713-459-2754
Mailing Address - Street 1:11660 WESTHEIMER RD STE 125
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-6798
Mailing Address - Country:US
Mailing Address - Phone:281-752-4100
Mailing Address - Fax:
Practice Address - Street 1:11660 WESTHEIMER RD STE 125
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-6798
Practice Address - Country:US
Practice Address - Phone:281-752-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8180TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty