Provider Demographics
NPI:1235803990
Name:CLYDE VISION, PLLC
Entity Type:Organization
Organization Name:CLYDE VISION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:LOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-814-3937
Mailing Address - Street 1:208 W COOMBS ST
Mailing Address - Street 2:
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-2827
Mailing Address - Country:US
Mailing Address - Phone:713-814-3937
Mailing Address - Fax:713-814-3897
Practice Address - Street 1:208 W COOMBS ST
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-2827
Practice Address - Country:US
Practice Address - Phone:713-814-3937
Practice Address - Fax:713-814-3897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty