Provider Demographics
NPI:1205264207
Name:FIRST VISION CARE PLLC
Entity type:Organization
Organization Name:FIRST VISION CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNITA
Authorized Official - Middle Name:N
Authorized Official - Last Name:SUNESRA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-213-6607
Mailing Address - Street 1:2650 S STATE HIGHWAY 161
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-7205
Mailing Address - Country:US
Mailing Address - Phone:817-213-6607
Mailing Address - Fax:817-608-7879
Practice Address - Street 1:2650 S STATE HIGHWAY 161
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052
Practice Address - Country:US
Practice Address - Phone:817-213-6607
Practice Address - Fax:817-608-7879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8328-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty