Healthcare Provider Details

I. General information

NPI: 1598043317
Provider Name (Legal Business Name): HOUSTON OPTIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2011
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N RIVERSHIRE DR STE 160
CONROE TX
77304
US

IV. Provider business mailing address

2855 GRAMERCY ST STE 400
HOUSTON TX
77025-1756
US

V. Phone/Fax

Practice location:
  • Phone: 936-756-1466
  • Fax:
Mailing address:
  • Phone: 713-668-6828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: THOMAS MERKLE
Title or Position: CHIEF INFORMATION OFFICER
Credential:
Phone: 713-668-6828