Provider Demographics
NPI:1407074214
Name:VISION PARK FAMILY EYE CARE
Entity Type:Organization
Organization Name:VISION PARK FAMILY EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:515-270-2490
Mailing Address - Street 1:475 S 50TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-6981
Mailing Address - Country:US
Mailing Address - Phone:515-225-8667
Mailing Address - Fax:515-270-2494
Practice Address - Street 1:2699 86TH ST
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-4309
Practice Address - Country:US
Practice Address - Phone:515-270-2490
Practice Address - Fax:515-270-2494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty