Vision Source - Kingwood, PA
NPI 1265564769ActiveOrganization· Optometrist· Kingwood, TX
Optometrist in Kingwood, Texas, registered in NPPES in March 2007. The authorized official on file is Glenn D. Ellisor, O.D., President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1265564769 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 10, 2007 |
| Last updated in NPPES | Jun 21, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | 03337TG | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|
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