Healthcare Provider Details

I. General information

NPI: 1023177292
Provider Name (Legal Business Name): KUYKENDAHL EYE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16140 KUYKENDAHL RD
HOUSTON TX
77068-3338
US

IV. Provider business mailing address

16140 KUYKENDAHL RD
HOUSTON TX
77068-3338
US

V. Phone/Fax

Practice location:
  • Phone: 281-537-9191
  • Fax: 281-537-9906
Mailing address:
  • Phone: 281-537-9191
  • Fax: 281-537-9906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number03510TG
License Number StateTX

VIII. Authorized Official

Name: WILLIAM F. MOYER
Title or Position: PRESIDENT
Credential: O.D.
Phone: 281-537-9191