Provider Demographics
NPI:1639482615
Name:SPECTRUM VISION, PLLC
Entity Type:Organization
Organization Name:SPECTRUM VISION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VI
Authorized Official - Middle Name:TUONG
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-369-2064
Mailing Address - Street 1:1001 LUCY LN
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-6398
Mailing Address - Country:US
Mailing Address - Phone:972-369-2064
Mailing Address - Fax:888-398-3803
Practice Address - Street 1:2201 S I-35 E STE D
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-8191
Practice Address - Country:US
Practice Address - Phone:940-591-7701
Practice Address - Fax:888-398-3803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7095TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty