Provider Demographics
NPI:1376152413
Name:AYALA VISTA EYECARE PLLC
Entity Type:Organization
Organization Name:AYALA VISTA EYECARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:CLARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIETO AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:832-997-3193
Mailing Address - Street 1:11670 PINEMONT RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77328-7237
Mailing Address - Country:US
Mailing Address - Phone:832-960-4261
Mailing Address - Fax:346-414-0048
Practice Address - Street 1:20854 US HIGHWAY 59 STE M
Practice Address - Street 2:
Practice Address - City:NEW CANEY
Practice Address - State:TX
Practice Address - Zip Code:77357-8384
Practice Address - Country:US
Practice Address - Phone:832-997-3193
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-24
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty