MEDICARE: EYE HEALTH & SURGICAL CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	K0979	TX

General Provider Information

NPI Number	:	1033343165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE HEALTH & SURGICAL CARE

Provider Business Mailing Address
First Line	:	3100 TIMMONS LANE
Second Line	:	SUITE 150
City	:	HOUSTON
State	:	TX
Zip	:	77027-5938
Country	:	US
Telephone Number	:	713-529-3867
Fax Number	:	713-529-2121

Provider Business Practice Location Address
First Line	:	3100 TIMMONS LANE
Second Line	:	SUITE 150
City	:	HOUSTON
State	:	TX
Zip	:	77027-5938
Country	:	US
Telephone Number	:	713-529-3867
Fax Number	:	713-529-2121

Authorized Official
Title or Position	:	SOLE PROPRIETER
Name	:	NIMISHA A PATEL
Credential	:	M.D.
Telephone Number	:	713-529-3867

Provider Enumeration Date	:	05/04/2009
Last Update Date	:	01/14/2010

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