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General NPI Number Information
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NPI Number | 1033649066
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Entity Type | Organization
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Legal Business Name | BAYBROOK MODERN EYECARE, P.L.L.C
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Dates
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Enumeration Date | 06/13/2017
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Last Update Date | 08/28/2026
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Provider Practice Location Address
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Address Line | 19052 GULF FWY
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-2703
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Country | US
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Telephone | 281-486-5064
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Fax | 281-306-5619
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Provider Business Mailing Address
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Address Line | 19052 GULF FWY
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-2703
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Country | US
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Telephone | 281-486-5064
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Fax | 281-306-5619
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Authorized Official
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Title or Position | ASSOCIATE/OPTOMETRIST
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Name | JOE MICHAEL SALAZAR
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Credential | OD
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Telephone | 832-385-0204
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 6618TG
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License Number State | TX
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