Healthcare Provider Details

I. General information

NPI: 1225230600
Provider Name (Legal Business Name): COLONY EYE CARE CENTER, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4511 SWEETWATER BLVD
SUGAR LAND TX
77479-3010
US

IV. Provider business mailing address

4511 SWEETWATER BLVD
SUGAR LAND TX
77479-3010
US

V. Phone/Fax

Practice location:
  • Phone: 281-265-2020
  • Fax: 281-265-2029
Mailing address:
  • Phone: 281-265-2020
  • Fax: 281-265-2029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: VICKI HAMMOND
Title or Position: INSURANCE COORDINATOR
Credential:
Phone: 281-265-2020