| NPI | 1689708919 |
|---|---|
| Former Legal Business Name | VISION SOURCE GREENWAY - GALLERIA, PA |
| Entity Type | Organization |
| Authorized Contact | AMY PARKER Authorized Official 832-403-3603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX 03077TG) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2021-03-19 |