Healthcare Provider Details

I. General information

NPI: 1427995992
Provider Name (Legal Business Name): EYEMART EXPRESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 W DAVIS ST STE G
CONROE TX
77304-2345
US

IV. Provider business mailing address

1302 W DAVIS ST STE G
CONROE TX
77304-2345
US

V. Phone/Fax

Practice location:
  • Phone: 936-323-6425
  • Fax: 936-323-6469
Mailing address:
  • Phone: 936-323-6425
  • Fax: 936-323-6469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: KIM CARUSO
Title or Position: DIRECTOR OF CREDENTIALING
Credential:
Phone: 646-660-1993