Healthcare Provider Details

I. General information

NPI: 1720130149
Provider Name (Legal Business Name): LA SPITZBERG OD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 02/26/2009
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 Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. LARRY A. SPITZBERG
Title or Position: PRESIDENT
Credential: OD
Phone: 281-497-2988