Provider Demographics
NPI:1457597700
Name:ARLINGTON VISION CARE
Entity Type:Organization
Organization Name:ARLINGTON VISION CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:CROSIER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-557-4100
Mailing Address - Street 1:3330 MATLOCK RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-2917
Mailing Address - Country:US
Mailing Address - Phone:817-557-4100
Mailing Address - Fax:817-557-4176
Practice Address - Street 1:3330 MATLOCK RD
Practice Address - Street 2:SUITE 104
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2917
Practice Address - Country:US
Practice Address - Phone:817-557-4100
Practice Address - Fax:817-557-4176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX04961TG261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0191744-01Medicaid
TXU52674Medicare UPIN
TX0191744-01Medicaid