Provider Demographics
NPI:1518201540
Name:GRACE VISION INC
Entity Type:Organization
Organization Name:GRACE VISION INC
Other - Org Name:THE PLANO EYE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GULREZ
Authorized Official - Middle Name:
Authorized Official - Last Name:KHOJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-401-8141
Mailing Address - Street 1:4104 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5860
Mailing Address - Country:US
Mailing Address - Phone:972-964-3937
Mailing Address - Fax:
Practice Address - Street 1:4104 W 15TH ST
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5860
Practice Address - Country:US
Practice Address - Phone:972-964-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty