Provider Demographics
NPI:1770695413
Name:TEAM VISION MARKETING GROUP LLC
Entity type:Organization
Organization Name:TEAM VISION MARKETING GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-355-8791
Mailing Address - Street 1:12705 S KIRKWOOD RD
Mailing Address - Street 2:STE 213
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3819
Mailing Address - Country:US
Mailing Address - Phone:281-277-1991
Mailing Address - Fax:281-277-1552
Practice Address - Street 1:12705 S KIRKWOOD RD
Practice Address - Street 2:STE 213
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3819
Practice Address - Country:US
Practice Address - Phone:281-277-1991
Practice Address - Fax:281-277-1552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0105917297Medicare NSC