Provider Demographics
NPI:1780038349
Name:BELLA VISION SERVICES LLC
Entity Type:Organization
Organization Name:BELLA VISION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FARSHID
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-316-6085
Mailing Address - Street 1:9577 HUEBNER RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1687
Mailing Address - Country:US
Mailing Address - Phone:210-641-4999
Mailing Address - Fax:210-641-4998
Practice Address - Street 1:9577 HUEBNER RD
Practice Address - Street 2:SUITE 3
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1687
Practice Address - Country:US
Practice Address - Phone:210-641-4999
Practice Address - Fax:210-641-4998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4766TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156083101Medicaid
TX00E44TMedicare UPIN