Provider Demographics
NPI:1447420534
Name:VISIONS OPTIQUE, INC
Entity Type:Organization
Organization Name:VISIONS OPTIQUE, INC
Other - Org Name:VISIONS OPTIQUE & EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:CLEPPER
Authorized Official - Last Name:UELNER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:480-515-2727
Mailing Address - Street 1:18291 N PIMA RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5697
Mailing Address - Country:US
Mailing Address - Phone:480-515-2727
Mailing Address - Fax:480-515-2747
Practice Address - Street 1:18291 N PIMA RD
Practice Address - Street 2:SUITE 120
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-5697
Practice Address - Country:US
Practice Address - Phone:480-515-2727
Practice Address - Fax:480-515-2747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1375152W00000X
AZ1375R152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1447420534OtherNPI
AZZ12618Medicare PIN