Provider Demographics
NPI:1649481300
Name:VISION CORNER UPTOWN LTD
Entity type:Organization
Organization Name:VISION CORNER UPTOWN LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF OPTOMETRY
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:W
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTOR OF OPTOMETRY
Authorized Official - Phone:281-498-1381
Mailing Address - Street 1:4725 WESTHEIMER RD STE 110
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-4717
Mailing Address - Country:US
Mailing Address - Phone:713-623-2000
Mailing Address - Fax:713-623-2007
Practice Address - Street 1:5000 WESTHEIMER RD STE 590
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-5618
Practice Address - Country:US
Practice Address - Phone:713-623-2000
Practice Address - Fax:713-623-2007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3314TG152W00000X, 152WC0802X, 152WP0200X
TX2744T152WC0802X, 152WS0006X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXY22868Medicare UPIN
TX00376YMedicare PIN