Provider Demographics
NPI:1225494065
Name:VISION ENHANCEMENT CENTER, INC
Entity Type:Organization
Organization Name:VISION ENHANCEMENT CENTER, INC
Other - Org Name:THE CENTER FOR VISION ENHANCEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVINEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-822-0900
Mailing Address - Street 1:4501 MCCULLOUGH AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212
Mailing Address - Country:US
Mailing Address - Phone:210-822-0900
Mailing Address - Fax:210-822-1299
Practice Address - Street 1:84 NE LOOP 410
Practice Address - Street 2:SUITE 140
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216
Practice Address - Country:US
Practice Address - Phone:210-822-0900
Practice Address - Fax:210-340-3841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5899TG152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU91639Medicare UPIN