MEDICARE: COPPERFIELD VISION CENTER, 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	5441TG	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710172044
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COPPERFIELD VISION CENTER, INC

Provider Business Mailing Address
First Line	:	7085 HIGHWAY 6 N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-2505
Country	:	US
Telephone Number	:	281-463-8333
Fax Number	:	281-463-8727

Provider Business Practice Location Address
First Line	:	7085 HIGHWAY 6 N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-2505
Country	:	US
Telephone Number	:	281-463-8333
Fax Number	:	281-463-8727

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CATHERINE D ONG
Credential	:	OD
Telephone Number	:	281-463-8333

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	08/29/2014

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Directions to “COPPERFIELD VISION CENTER, INC ” Practice Location

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