Provider Demographics
NPI:1740773795
Name:ARLINGTON VISION SOURCE PC
Entity Type:Organization
Organization Name:ARLINGTON VISION SOURCE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OD
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCHUNK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-461-4453
Mailing Address - Street 1:1334 E PIONEER PKWY
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-6411
Mailing Address - Country:US
Mailing Address - Phone:817-461-4453
Mailing Address - Fax:832-934-1161
Practice Address - Street 1:1334 E PIONEER PKWY
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-6411
Practice Address - Country:US
Practice Address - Phone:817-461-4453
Practice Address - Fax:832-934-1161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty