Provider Demographics
NPI:1407181043
Name:TODAY'S VISION OAK CLIFF PLLC
Entity Type:Organization
Organization Name:TODAY'S VISION OAK CLIFF PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:214-331-4700
Mailing Address - Street 1:3420 W ILLINOIS AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75211-8722
Mailing Address - Country:US
Mailing Address - Phone:214-331-4700
Mailing Address - Fax:214-331-4712
Practice Address - Street 1:3420 W ILLINOIS AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-8722
Practice Address - Country:US
Practice Address - Phone:214-331-4700
Practice Address - Fax:214-331-4712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-15
Last Update Date:2010-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7234T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2107096-01Medicaid
TX7234TOtherTEXAS OPTOMETRY LICENSE
TX0A5380Medicare PIN