Provider Demographics
NPI:1679889778
Name:VISION CONCEPTS
Entity type:Organization
Organization Name:VISION CONCEPTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BELLO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:254-865-7979
Mailing Address - Street 1:113 N LUTTERLOH AVE
Mailing Address - Street 2:
Mailing Address - City:GATESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76528-1421
Mailing Address - Country:US
Mailing Address - Phone:254-865-7979
Mailing Address - Fax:254-865-2605
Practice Address - Street 1:113 N LUTTERLOH AVE
Practice Address - Street 2:
Practice Address - City:GATESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76528-1421
Practice Address - Country:US
Practice Address - Phone:254-865-7979
Practice Address - Fax:254-865-2605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4428T332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX281299OtherSCOTT & WHITE HEALTH PLAN