Provider Demographics
NPI:1962754242
Name:VISUAL EYES
Entity type:Organization
Organization Name:VISUAL EYES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLESTEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RIFFE
Authorized Official - Suffix:
Authorized Official - Credentials:ABOC
Authorized Official - Phone:936-327-9747
Mailing Address - Street 1:117 SOUTHPOINT LOOP
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-8899
Mailing Address - Country:US
Mailing Address - Phone:936-327-9747
Mailing Address - Fax:936-327-9747
Practice Address - Street 1:117 SOUTHPOINT LOOP
Practice Address - Street 2:SUITE 200
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-8899
Practice Address - Country:US
Practice Address - Phone:936-327-9747
Practice Address - Fax:936-327-9747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier