Provider Demographics
NPI:1114212628
Name:VIZIO OPTICAL INC
Entity type:Organization
Organization Name:VIZIO OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUNG
Authorized Official - Middle Name:HUY
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-772-2020
Mailing Address - Street 1:6002 ROGERDALE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-1659
Mailing Address - Country:US
Mailing Address - Phone:713-772-2020
Mailing Address - Fax:713-772-2015
Practice Address - Street 1:6002 ROGERDALE RD STE 150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072
Practice Address - Country:US
Practice Address - Phone:713-772-2020
Practice Address - Fax:713-772-2015
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUNG LE EYE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-13
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6566900001Medicare NSC