Healthcare Provider Details

I. General information

NPI: 1083726343
Provider Name (Legal Business Name): SOPHIA W. BARNES O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 WESTHEIMER RD SUITE 590
HOUSTON TX
77056-5613
US

IV. Provider business mailing address

4725 WESTHEIMER RD STE 590
HOUSTON TX
77027-4717
US

V. Phone/Fax

Practice location:
  • Phone: 713-623-2000
  • Fax: 713-623-2007
Mailing address:
  • Phone: 713-623-2000
  • Fax: 713-623-2007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number3314TG
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number3314TG
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number3314TG
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3314TG
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number3314TG
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: