Provider Demographics
NPI:1407049521
Name:BRIGHTER VISTAS, LLC
Entity type:Organization
Organization Name:BRIGHTER VISTAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VELDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DESADIER
Authorized Official - Suffix:
Authorized Official - Credentials:MED, DIAGNOSTICIAN
Authorized Official - Phone:936-232-2907
Mailing Address - Street 1:18057 HWY. 105 WEST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356
Mailing Address - Country:US
Mailing Address - Phone:936-582-5620
Mailing Address - Fax:936-582-5621
Practice Address - Street 1:18057 HIGHWAY 105 W
Practice Address - Street 2:SUITE 220
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-5985
Practice Address - Country:US
Practice Address - Phone:936-582-5620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty