Organization
KELVIN VAN VOORST, OD AND STACIE HOUGHTALEN, OD, PA
Active
Other names
Prosper Family Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELVIN MARK VAN VOORST O.D. (PRESIDENT)
(972) 347-2004
Entity
Organization
Contact information
Practice address
110 NORTH PRESTON ROAD, SUITE 30, PROSPER, TX 75078-8794
(972) 347-2004
(972) 347-3847
Mailing address
110 NORTH PRESTON ROAD, SUITE 30, PROSPER, TX 75078-8794
(972) 347-2004
(972) 347-3847
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
6554TG
TX
152W00000X
Optometrist
Primary
6563TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255350740
NPI-STACIE VAN VOORST, OD
TX
01
—
1396764882
NPI-KELVIN VAN VOORST, OD
TX
Enumeration date
10/24/2006
Last updated
08/22/2020
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