Provider Demographics
NPI:1134208382
Name:TODAYS VISION
Entity type:Organization
Organization Name:TODAYS VISION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-395-8434
Mailing Address - Street 1:3645 DALLAS PKWY
Mailing Address - Street 2:535
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7775
Mailing Address - Country:US
Mailing Address - Phone:972-608-9906
Mailing Address - Fax:972-608-9974
Practice Address - Street 1:3645 DALLAS PKWY
Practice Address - Street 2:535
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7775
Practice Address - Country:US
Practice Address - Phone:972-608-9906
Practice Address - Fax:972-608-9974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5216TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXX81421Medicare UPIN
TX00434UMedicare ID - Type UnspecifiedMEDICARE GRP ID