Healthcare Provider Details

I. General information

NPI: 1316536931
Provider Name (Legal Business Name): EYE DOCTOR HOUSTON PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2021
Last Update Date: 01/18/2021
Certification Date: 01/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4899 GRIGGS RD
HOUSTON TX
77021-2855
US

IV. Provider business mailing address

4899 GRIGGS RD
HOUSTON TX
77021-2855
US

V. Phone/Fax

Practice location:
  • Phone: 713-748-5000
  • Fax:
Mailing address:
  • Phone: 713-748-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. CHIKE MORDI
Title or Position: PRESIDENT
Credential:
Phone: 832-452-3596