Healthcare Provider Details

I. General information

NPI: 1194542720
Provider Name (Legal Business Name): SUMMIT SIGHT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7115 SOUTHWEST FWY
HOUSTON TX
77074-2001
US

IV. Provider business mailing address

2211 VILLAGE DALE AVE
HOUSTON TX
77059-3591
US

V. Phone/Fax

Practice location:
  • Phone: 713-981-6021
  • 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: VINCENT LAM
Title or Position: MANAGING MEMBER
Credential:
Phone: 832-605-7103