Provider Demographics
NPI:1467998054
Name:STRONG VISION FAIRFIELD, P.A.
Entity Type:Organization
Organization Name:STRONG VISION FAIRFIELD, P.A.
Other - Org Name:STRONG VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:STRONG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-373-3063
Mailing Address - Street 1:28070 HIGHWAY 290
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5470
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:28070 HIGHWAY 290
Practice Address - Street 2:SUITE 120
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-5470
Practice Address - Country:US
Practice Address - Phone:281-373-3063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU83327Medicare UPIN