Healthcare Provider Details
I. General information
NPI: 1710217054
Provider Name (Legal Business Name): APEX EYE CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/08/2010
Last Update Date: 03/24/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2401 N 16TH ST
ORANGE TX
77630-2331
US
IV. Provider business mailing address
2211 VILLAGE DALE AVE
HOUSTON TX
77059-3591
US
V. Phone/Fax
- Phone: 409-385-5262
- Fax: 409-385-6497
- Phone: 832-605-7103
- Fax: 832-224-4766
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 7406TG |
| License Number State | TX |
VIII. Authorized Official
Name:
VINCENT
WING-WAH
LAM
Title or Position: MANAGING MEMBER
Credential:
Phone: 832-605-7103