Provider Demographics
NPI:1619515616
Name:BERING SEE VISION LLC
Entity Type:Organization
Organization Name:BERING SEE VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TRUONG
Authorized Official - Middle Name:THANH
Authorized Official - Last Name:PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:469-222-8866
Mailing Address - Street 1:PO BOX 1785
Mailing Address - Street 2:
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762-1785
Mailing Address - Country:US
Mailing Address - Phone:469-222-8866
Mailing Address - Fax:
Practice Address - Street 1:922 E FRONT ST
Practice Address - Street 2:
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762-1785
Practice Address - Country:US
Practice Address - Phone:469-222-8866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-20
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty