Provider Demographics
NPI:1578747275
Name:ODESSA VISION CENTER PLLC
Entity Type:Organization
Organization Name:ODESSA VISION CENTER PLLC
Other - Org Name:VISION SOURCE ODESSA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HEMBREE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:432-362-3133
Mailing Address - Street 1:4015 PENBROOK ST
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-5917
Mailing Address - Country:US
Mailing Address - Phone:432-362-3133
Mailing Address - Fax:432-362-4818
Practice Address - Street 1:4015 PENBROOK ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-5917
Practice Address - Country:US
Practice Address - Phone:432-362-3133
Practice Address - Fax:432-362-4818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2713-TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty