Provider Demographics
NPI:1023511235
Name:ARLINGTON VISION CARE PA
Entity type:Organization
Organization Name:ARLINGTON VISION CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:CROSIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-557-4100
Mailing Address - Street 1:5425 MATLOCK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-1558
Mailing Address - Country:US
Mailing Address - Phone:817-557-4100
Mailing Address - Fax:817-557-4176
Practice Address - Street 1:5425 MATLOCK RD STE 100
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1558
Practice Address - Country:US
Practice Address - Phone:817-557-4100
Practice Address - Fax:817-557-4176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4961TG261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center