Provider Demographics
NPI:1609196393
Name:NW VISION CARE ASSOCIATES, PA
Entity Type:Organization
Organization Name:NW VISION CARE ASSOCIATES, PA
Other - Org Name:TEXAS STATE OPTICAL NW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LY
Authorized Official - Middle Name:H
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-758-0008
Mailing Address - Street 1:564 NORTHWEST MALL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-8544
Mailing Address - Country:US
Mailing Address - Phone:713-681-2467
Mailing Address - Fax:713-681-0537
Practice Address - Street 1:564 NORTHWEST MALL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-8544
Practice Address - Country:US
Practice Address - Phone:713-681-2467
Practice Address - Fax:713-681-0537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6457TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty