Healthcare Provider Details

I. General information

NPI: 1306002001
Provider Name (Legal Business Name): AMRITA K BAINS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 08/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25905 HIGHWAY 290 SUITE A
CYPRESS TX
77429-1004
US

IV. Provider business mailing address

8927 ABER TRAIL CT
HOUSTON TX
77095-4805
US

V. Phone/Fax

Practice location:
  • Phone: 713-446-6621
  • Fax:
Mailing address:
  • Phone: 713-446-6621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: AMRITA BAINS
Title or Position: DIRECTOR
Credential: O.D.
Phone: 713-446-6621