Provider Demographics
NPI:1760849897
Name:VISION PARK DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:VISION PARK DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:361-652-0025
Mailing Address - Street 1:PO BOX 3525
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77903-3525
Mailing Address - Country:US
Mailing Address - Phone:361-485-9400
Mailing Address - Fax:361-485-9933
Practice Address - Street 1:114 VISION PARK BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3008
Practice Address - Country:US
Practice Address - Phone:936-321-1700
Practice Address - Fax:936-273-8900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory