Provider Demographics
NPI:1356705131
Name:VGR VISION, INC
Entity type:Organization
Organization Name:VGR VISION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RONIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-392-7881
Mailing Address - Street 1:1450 EASTCHASE PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76120-4429
Mailing Address - Country:US
Mailing Address - Phone:817-460-1600
Mailing Address - Fax:
Practice Address - Street 1:309 S OAKLAND BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76103
Practice Address - Country:US
Practice Address - Phone:817-534-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-07
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty