Provider Demographics
NPI:1750597423
Name:WHITSETT VISION GROUP PLLC
Entity type:Organization
Organization Name:WHITSETT VISION GROUP PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANI
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-581-6827
Mailing Address - Street 1:23510 KINGSLAND BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-4125
Mailing Address - Country:US
Mailing Address - Phone:713-581-6833
Mailing Address - Fax:281-395-7004
Practice Address - Street 1:1237 CAMPBELL RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-6453
Practice Address - Country:US
Practice Address - Phone:713-365-9099
Practice Address - Fax:713-365-9356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00376ROtherMEDICARE PTAN
TXE65021Medicare UPIN