Provider Demographics
NPI:1962748673
Name:VISION MAX PA
Entity type:Organization
Organization Name:VISION MAX PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:F
Authorized Official - Last Name:PLANTY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:713-450-2020
Mailing Address - Street 1:13427 EAST FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-5901
Mailing Address - Country:US
Mailing Address - Phone:713-450-2020
Mailing Address - Fax:713-451-3937
Practice Address - Street 1:13427 EAST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-5901
Practice Address - Country:US
Practice Address - Phone:713-450-2020
Practice Address - Fax:713-451-3937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-27
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2630T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W92846Medicare UPIN