Provider Demographics
NPI:1174022891
Name:TEXAS VISION CLINIC PLLC
Entity Type:Organization
Organization Name:TEXAS VISION CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUKAR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-743-4373
Mailing Address - Street 1:87 LOOP 150 W
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-3930
Mailing Address - Country:US
Mailing Address - Phone:512-321-2106
Mailing Address - Fax:
Practice Address - Street 1:85 LOOP 150 W
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-3930
Practice Address - Country:US
Practice Address - Phone:512-321-2106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-08
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier