Provider Demographics
NPI:1356851653
Name:BELLAIRE VISION PLLC
Entity Type:Organization
Organization Name:BELLAIRE VISION PLLC
Other - Org Name:SONIK VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STACY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:SONIK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:713-664-6565
Mailing Address - Street 1:4710 BELLAIRE BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4521
Mailing Address - Country:US
Mailing Address - Phone:713-664-6565
Mailing Address - Fax:713-664-9633
Practice Address - Street 1:4710 BELLAIRE BLVD STE 160
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4521
Practice Address - Country:US
Practice Address - Phone:713-664-6565
Practice Address - Fax:713-664-9633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5278TG261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty