MEDICARE: AT FIRST SIGHT INC

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	152W00000X	Optometrist	7283TG	TX

General Provider Information

NPI Number	:	1689040610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AT FIRST SIGHT INC

Provider Business Mailing Address
First Line	:	1900 NORTH LOOP W STE 140
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-8151
Country	:	US
Telephone Number	:	713-943-9477
Fax Number	:	713-943-2867

Provider Business Practice Location Address
First Line	:	1900 NORTH LOOP W STE 140
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-8151
Country	:	US
Telephone Number	:	713-943-9477
Fax Number	:	713-943-2867

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID M JOHNSON
Credential	:	OD
Telephone Number	:	713-943-9477

Provider Enumeration Date	:	08/13/2015
Last Update Date	:	11/20/2015

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Directions to “AT FIRST SIGHT INC ” Practice Location

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