Provider Demographics
NPI:1538582127
Name:COLONY VISION CENTER PC
Entity type:Organization
Organization Name:COLONY VISION CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:OD/OWNER
Authorized Official - Phone:972-624-5967
Mailing Address - Street 1:4709 HIGHWAY 121
Mailing Address - Street 2:SUITE 122
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-2914
Mailing Address - Country:US
Mailing Address - Phone:972-625-2020
Mailing Address - Fax:972-624-5357
Practice Address - Street 1:4709 HIGHWAY 121
Practice Address - Street 2:SUITE 122
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-2914
Practice Address - Country:US
Practice Address - Phone:972-625-2020
Practice Address - Fax:972-624-5357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty