Healthcare Provider Details
I. General information
NPI: 1457711475
Provider Name (Legal Business Name): PRECISION FAMILY EYECARE PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/03/2016
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10120 GREENHOUSE ROAD SUITE 102
CYPRESS TX
77433
US
IV. Provider business mailing address
10120 GREENHOUSE ROAD SUITE 102
CYPRESS TX
77433
US
V. Phone/Fax
- Phone: 832-934-1166
- Fax: 832-934-1161
- Phone: 832-934-1166
- Fax: 832-934-1161
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JUSTIN
R
DOUGLASS
Title or Position: OD/OWNER
Credential: OD/OWNER
Phone: 832-934-1166