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Organization
VISIONARY EYECARE CENTER LLC
Active
Organization
VISIONARY EYECARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALISHA POONAWALA OD (OPTOMETRIST)
(817) 932-2498
Entity
Organization
Contact information
Practice address
1217 OAK KNOLL DR, FORT WORTH, TX 76117-5505
(817) 932-2498
Mailing address
1342 WOODBROOK CT, SOUTHLAKE, TX 76092-4835
(817) 932-2498
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9206TG
TX
Other
Enumeration date
11/18/2017
Last updated
01/09/2018
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