Healthcare Provider Details

I. General information

NPI: 1710461728
Provider Name (Legal Business Name): BRIARGROVE EYECARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2018
Last Update Date: 09/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 WESTHEIMER RD STE 138
HOUSTON TX
77057-4535
US

IV. Provider business mailing address

6100 WESTHEIMER RD STE 138
HOUSTON TX
77057-4535
US

V. Phone/Fax

Practice location:
  • Phone: 713-714-1608
  • Fax: 832-934-1161
Mailing address:
  • Phone: 713-714-1608
  • Fax: 832-934-1161

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