Provider Demographics
NPI:1689841041
Name:CLEAR VISION OPTOMETRY, P.C.
Entity type:Organization
Organization Name:CLEAR VISION OPTOMETRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:O.D./ MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM CHI
Authorized Official - Middle Name:THI
Authorized Official - Last Name:TRINH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-835-9226
Mailing Address - Street 1:9616 N LAMAR BLVD STE 159
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-4150
Mailing Address - Country:US
Mailing Address - Phone:512-835-9226
Mailing Address - Fax:
Practice Address - Street 1:9616 N LAMAR BLVD STE 159
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-4150
Practice Address - Country:US
Practice Address - Phone:512-835-9226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6997T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty