Provider Demographics
NPI:1588958235
Name:VISIBLE IMAGE
Entity type:Organization
Organization Name:VISIBLE IMAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MCWILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-373-6775
Mailing Address - Street 1:15350 E HUTCHINSON CIR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-3328
Mailing Address - Country:US
Mailing Address - Phone:713-373-6775
Mailing Address - Fax:
Practice Address - Street 1:6201 BONHOMME RD
Practice Address - Street 2:SUITE 388N
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-4365
Practice Address - Country:US
Practice Address - Phone:713-785-2233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-29
Last Update Date:2011-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251G00000X, 251J00000X, 253J00000X
TX253Z00000X, 302F00000X, 3245S0500X
TX801126049385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No302F00000XManaged Care OrganizationsExclusive Provider Organization
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
No385H00000XRespite Care FacilityRespite Care