Healthcare Provider Details

I. General information

NPI: 1063192565
Provider Name (Legal Business Name): EADO EYE STUDIO, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

2921 RIVERBY RD STE 104
HOUSTON TX
77020-1800
US

IV. Provider business mailing address

914 CULLEN BLVD
HOUSTON TX
77023-1653
US

V. Phone/Fax

Practice location:
  • Phone: 832-975-7020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: CHI-QUANG PETER NGUYEN
Title or Position: OPTOMETRIST
Credential: OD
Phone: 832-660-7176