MEDICARE: BERKELEY EYE INSTITUTE PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332H00000X	Eyewear Supplier
2	152W00000X	Optometrist
3	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1437913191
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BERKELEY EYE INSTITUTE PLLC

Provider Business Mailing Address
First Line	:	21502 MERCHANTS WAY
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-2517
Country	:	US
Telephone Number	:	281-944-2232
Fax Number	:	281-944-2290

Provider Business Practice Location Address
First Line	:	7438 HARRISBURG BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77011-4741
Country	:	US
Telephone Number	:	713-928-3375
Fax Number	:	713-928-6173

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MARK MICHELETTI
Credential	:
Telephone Number	:	281-348-4615

Provider Enumeration Date	:	02/12/2024
Last Update Date	:	02/12/2024

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Directions to “BERKELEY EYE INSTITUTE PLLC ” Practice Location

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