Provider Demographics
NPI:1154690162
Name:VISION PRO
Entity Type:Organization
Organization Name:VISION PRO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-865-9528
Mailing Address - Street 1:207 W HICKORY ST
Mailing Address - Street 2:STE 100
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-4156
Mailing Address - Country:US
Mailing Address - Phone:940-566-2280
Mailing Address - Fax:940-566-0994
Practice Address - Street 1:207 W HICKORY ST
Practice Address - Street 2:STE 100
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-4156
Practice Address - Country:US
Practice Address - Phone:940-566-2280
Practice Address - Fax:940-566-0994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty