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