Provider Demographics
NPI:1285667725
Name:VISION TECH OPTICAL
Entity Type:Organization
Organization Name:VISION TECH OPTICAL
Other - Org Name:VISION TEC OPTICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDRICK
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:GREENWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-547-9500
Mailing Address - Street 1:2310 N. EXPRESSWAY
Mailing Address - Street 2:SUITE G
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521
Mailing Address - Country:US
Mailing Address - Phone:956-547-9500
Mailing Address - Fax:956-547-9500
Practice Address - Street 1:2310 N EXPRESSWAY
Practice Address - Street 2:SUITE G
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-0903
Practice Address - Country:US
Practice Address - Phone:956-547-9500
Practice Address - Fax:956-547-9500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXCP00754156FC0800X
TX156FX1800X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No156FC0800XEye and Vision Services ProvidersTechnician/TechnologistContact LensGroup - Multi-Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty