Provider Demographics
NPI:1528408317
Name:ELITE FAMILY VISION PLLC
Entity Type:Organization
Organization Name:ELITE FAMILY VISION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORDANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHETTIPARAMPIL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-607-4545
Mailing Address - Street 1:17520 SOUTHWEST FREEWAY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479
Mailing Address - Country:US
Mailing Address - Phone:281-607-4545
Mailing Address - Fax:281-201-6418
Practice Address - Street 1:17520 SOUTHWEST FREEWAY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:281-607-4545
Practice Address - Fax:281-201-6418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty