Provider Demographics
NPI:1821537747
Name:VISIONCARE GROUP AT WEST 7TH, P.A.
Entity Type:Organization
Organization Name:VISIONCARE GROUP AT WEST 7TH, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LENA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-346-7077
Mailing Address - Street 1:3017 W 7TH ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-2223
Mailing Address - Country:US
Mailing Address - Phone:817-346-7077
Mailing Address - Fax:817-346-6998
Practice Address - Street 1:3017 W 7TH ST
Practice Address - Street 2:SUITE 210
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-2223
Practice Address - Country:US
Practice Address - Phone:817-346-7077
Practice Address - Fax:817-346-6998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3413TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty