Provider Demographics
NPI:1417058553
Name:VISION HEALTH SERVICES
Entity Type:Organization
Organization Name:VISION HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:TREPETIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-681-7865
Mailing Address - Street 1:3434 TOWNE CROSSING BLVD
Mailing Address - Street 2:112
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-2782
Mailing Address - Country:US
Mailing Address - Phone:972-681-7865
Mailing Address - Fax:972-681-4207
Practice Address - Street 1:3434 TOWNE CROSSING BLVD
Practice Address - Street 2:112
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-2782
Practice Address - Country:US
Practice Address - Phone:972-681-7865
Practice Address - Fax:972-681-4207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17822156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty