| NPI | 1033247598 |
|---|---|
| Doing Business As | VISION SOURCE OF TYLER |
| Entity Type | Organization |
| Authorized Contact | LARRY M CHISM Owner/O PT Ometrist 903-561-8686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 02774TG) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2012-05-17 |