Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
VISION SOURCE - KINGWOOD, PA
Active
Organization
VISION SOURCE - KINGWOOD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN D. ELLISOR O.D. (PRESIDENT)
(713) 995-0042
Entity
Organization
Contact information
Practice address
1714 KINGWOOD DR, KINGWOOD, TX 77339-3046
(713) 995-0042
(713) 995-0548
Mailing address
1714 KINGWOOD DR, KINGWOOD, TX 77339-3046
(713) 995-0042
(713) 995-0548
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
03337TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0046FE
BLUE CROSS & BLUE SHIELD
TX
Enumeration date
03/10/2007
Last updated
06/21/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up