Provider Demographics
NPI:1982064747
Name:DOWNTOWN FAMILY VISION LLC
Entity Type:Organization
Organization Name:DOWNTOWN FAMILY VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MORRISSEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD/OWNER
Authorized Official - Phone:832-934-1166
Mailing Address - Street 1:220 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WILBER
Mailing Address - State:NE
Mailing Address - Zip Code:68465-3193
Mailing Address - Country:US
Mailing Address - Phone:832-934-1166
Mailing Address - Fax:832-934-1161
Practice Address - Street 1:220 W 3RD ST
Practice Address - Street 2:
Practice Address - City:WILBER
Practice Address - State:NE
Practice Address - Zip Code:68465-3193
Practice Address - Country:US
Practice Address - Phone:832-934-1166
Practice Address - Fax:832-934-1161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty