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NPI Code Detail

MEDICARE: HOUSTON OPTIC, PLLC

MEDICARE: HOUSTON OPTIC, PLLC
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
1332H00000XEyewear Supplier
2332B00000XDurable Medical Equipment & Medical Supplies

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1600810021OTHERNSC
21558476788OTHERGROUP NPI

General Provider Information

NPI Number : 1497166607
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOUSTON OPTIC, PLLC
Provider Business Mailing Address
First Line : 2855 GRAMERCY
Second Line : SUITE 400
City : HOUSTON
State : TX
Zip : 77025-1756
Country : US
Telephone Number : 713-668-6828
Fax Number : 832-280-3636
Provider Business Practice Location Address
First Line : 1415 N. LOOP WEST
Second Line : SUITE 400
City : HOUSTON
State : TX
Zip : 77008-1646
Country : US
Telephone Number : 713-869-6400
Fax Number : 713-869-6498
Authorized Official
Title or Position : CHIEF INFORMATION OFFICER
Name : THOMAS MERKLE
Credential :
Telephone Number : 713-668-6828
Provider Enumeration Date : 05/12/2014
Last Update Date : 10/23/2023

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