Provider Demographics
NPI:1184803421
Name:20/20 VISION CARE INC
Entity type:Organization
Organization Name:20/20 VISION CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:FARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:956-630-2020
Mailing Address - Street 1:1313 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-5023
Mailing Address - Country:US
Mailing Address - Phone:956-630-2020
Mailing Address - Fax:956-630-2060
Practice Address - Street 1:1313 S 10TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-5023
Practice Address - Country:US
Practice Address - Phone:956-630-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3877152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00E71MOtherBCBS
TX110211OtherEYEMED
TX32713OtherOPTICARE
TX090753001OtherMEDICARE RAIL ROAD
TX093372302Medicaid
TX110211OtherEYEMED