Healthcare Provider Details

I. General information

NPI: 1699311969
Provider Name (Legal Business Name): EYETRENDS MEMORIAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2019
Last Update Date: 11/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14441 MEMORIAL DR STE 13
HOUSTON TX
77079-6737
US

IV. Provider business mailing address

14441 MEMORIAL DR STE 13
HOUSTON TX
77079-6737
US

V. Phone/Fax

Practice location:
  • Phone: 281-497-2988
  • Fax: 281-497-2919
Mailing address:
  • Phone: 281-497-2988
  • Fax: 281-497-2919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: EUDE A OSSORIO
Title or Position: CONSULTANT
Credential: CONSULTANT
Phone: 832-934-1166