Healthcare Provider Details

I. General information

NPI: 1679728521
Provider Name (Legal Business Name): TOWN SQUARE EYE ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2008
Last Update Date: 02/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16200 CITY WALK
SUGAR LAND TX
77479-6543
US

IV. Provider business mailing address

16200 CITY WALK
SUGAR LAND TX
77479-6543
US

V. Phone/Fax

Practice location:
  • Phone: 281-265-2000
  • Fax: 281-265-2141
Mailing address:
  • Phone: 281-265-2000
  • Fax: 281-265-2141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE N ZAIBAQ
Title or Position: OWNER
Credential: O.D.
Phone: 281-265-2000