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
1	332H00000X	Eyewear Supplier
2	332B00000X	Durable Medical Equipment & Medical Supplies		TX

General Provider Information

NPI Number	:	1679766521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON OPTIC, PLLC

Provider Business Mailing Address
First Line	:	2855 GRAMERCY ST STE 400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-1756
Country	:	US
Telephone Number	:	713-668-6828
Fax Number	:

Provider Business Practice Location Address
First Line	:	5614 E SAM HOUSTON PKWY N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015
Country	:	US
Telephone Number	:	713-678-8288
Fax Number	:

Authorized Official
Title or Position	:	CHIEF INFORMATION OFFICER
Name	:	THOMAS MERKLE
Credential	:
Telephone Number	:	713-668-6828

Provider Enumeration Date	:	08/23/2007
Last Update Date	:	09/19/2023

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Directions to “HOUSTON OPTIC, PLLC ” Practice Location

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