MEDICARE: RIVER OAKS VISION, P.A.

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

General Provider Information

NPI Number	:	1922133420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVER OAKS VISION, P.A.

Provider Business Mailing Address
First Line	:	1426 W GRAY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-4927
Country	:	US
Telephone Number	:	713-640-2020
Fax Number	:	713-520-7736

Provider Business Practice Location Address
First Line	:	1426 W GRAY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-4927
Country	:	US
Telephone Number	:	713-640-2020
Fax Number	:	713-520-7736

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BRUCE D KRUTSINGER
Credential	:	O.D.
Telephone Number	:	713-640-2020

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	12/14/2007

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