Provider Demographics
NPI:1467812024
Name:RDMD VISIONARY
Entity Type:Organization
Organization Name:RDMD VISIONARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:D
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:832-774-5834
Mailing Address - Street 1:24406 N TIDE BAY CIR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1584
Mailing Address - Country:US
Mailing Address - Phone:832-774-5834
Mailing Address - Fax:
Practice Address - Street 1:1721 SPRING GREEN BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1584
Practice Address - Country:US
Practice Address - Phone:832-774-5834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5646TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX299386701Medicaid
TXU71418Medicare UPIN
TXTXB120332Medicare PIN