Provider Demographics
NPI:1598948614
Name:RHONDA LYNN ANDERSON
Entity Type:Organization
Organization Name:RHONDA LYNN ANDERSON
Other - Org Name:FAMILY VISION CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-361-2020
Mailing Address - Street 1:25 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3710
Mailing Address - Country:US
Mailing Address - Phone:281-361-2020
Mailing Address - Fax:281-361-0702
Practice Address - Street 1:25 N MAIN ST
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3710
Practice Address - Country:US
Practice Address - Phone:281-361-2020
Practice Address - Fax:281-361-0702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3949TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1031820001Medicare NSC
TX00112SMedicare PIN
TXT11949Medicare UPIN