Basic Information
Provider Information
NPI: 1346639937
EntityType: 2
ReplacementNPI:  
OrganizationName: NATIONAL VISION, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: AMERICA'S BEST CONTACTS & EYEGLASSES
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2435 COMMERCE AVE
Address2: BLDG 2200
City: DULUTH
State: GA
PostalCode: 300964980
CountryCode: US
TelephoneNumber: 7708223600
FaxNumber:  
Practice Location
Address1: 20440 HWY 59 N
Address2: STE 100
City: HUMBLE
State: TX
PostalCode: 77338
CountryCode: US
TelephoneNumber: 2815407437
FaxNumber: 2815407445
Other Information
ProviderEnumerationDate: 01/20/2015
LastUpdateDate: 01/20/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: VAUGHN
AuthorizedOfficialFirstName: LEAHANN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: MANAGED CARE SALES COORDINATOR
AuthorizedOfficialTelephone: 4704482782
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
156FX1800X  Y193400000X SINGLE SPECIALTY GROUPEye and Vision Services ProvidersTechnician/TechnologistOptician

No ID Information.


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