Provider Demographics
NPI:1013258128
Name:VERICARE VISION PLLC
Entity type:Organization
Organization Name:VERICARE VISION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:XU
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-665-3521
Mailing Address - Street 1:5023 REDLEAF FOREST LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-4934
Mailing Address - Country:US
Mailing Address - Phone:281-665-3521
Mailing Address - Fax:
Practice Address - Street 1:1251 PIN OAK RD STE 128
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5659
Practice Address - Country:US
Practice Address - Phone:281-665-3521
Practice Address - Fax:281-310-8682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-14
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7936T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3330953Medicaid
TX3330953Medicaid
TX312908YUVRMedicare PIN