Provider Demographics
NPI:1295961118
Name:VISION MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:VISION MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRES
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:G
Authorized Official - Last Name:KIMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-709-3742
Mailing Address - Street 1:4230 BLUEBONNET DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-2911
Mailing Address - Country:US
Mailing Address - Phone:281-545-8464
Mailing Address - Fax:281-545-8452
Practice Address - Street 1:4230 BLUEBONNET DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-2911
Practice Address - Country:US
Practice Address - Phone:281-545-8464
Practice Address - Fax:281-545-8452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies