Healthcare Provider Details

I. General information

NPI: 1639369010
Provider Name (Legal Business Name): BELLAIRE EYE CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2726 BISSONNET ST 240-228
HOUSTON TX
77005-1319
US

IV. Provider business mailing address

2726 BISSONNET ST 240-228
HOUSTON TX
77005-1319
US

V. Phone/Fax

Practice location:
  • Phone: 832-934-1166
  • Fax: 832-934-1161
Mailing address:
  • Phone: 832-934-1166
  • Fax: 832-934-1161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number7128TG
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number7522T
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberE4710
License Number StateTX

VIII. Authorized Official

Name: ROSA A TANG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 832-934-1166