Provider Demographics
NPI:1134567464
Name:VALSA PATRIC MURINGATHUPARAMBIL
Entity type:Organization
Organization Name:VALSA PATRIC MURINGATHUPARAMBIL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF OPROMETRY
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALSA
Authorized Official - Middle Name:PATRIC
Authorized Official - Last Name:MURINGATHUPARAMBIL
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:512-501-9708
Mailing Address - Street 1:2608 N MAIN ST
Mailing Address - Street 2:# B - 247
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-1546
Mailing Address - Country:US
Mailing Address - Phone:254-939-9555
Mailing Address - Fax:512-532-7444
Practice Address - Street 1:2604 N MAIN ST
Practice Address - Street 2:FOCUS EYE CARE
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-1545
Practice Address - Country:US
Practice Address - Phone:254-939-9555
Practice Address - Fax:512-532-7444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-09
Last Update Date:2013-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6905TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty