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General NPI Number Information
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NPI Number | 1043498116
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Entity Type | Organization
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Legal Business Name | TEXAS EYE PROSTHETICS LLC
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Dates
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Enumeration Date | 01/31/2008
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 4203 MONTROSE BLVD STE 380
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City | HOUSTON
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State | TX
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Zip | 77006-5467
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Country | US
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Telephone | 713-524-1001
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Fax | 713-524-1004
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Provider Business Mailing Address
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Address Line | 4203 MONTROSE BLVD STE 380
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City | HOUSTON
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State | TX
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Zip | 77006-5467
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Country | US
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Telephone | 713-524-1001
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Fax | 713-524-1004
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Authorized Official
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Title or Position | SOLE MBR/OWNER/PRESIDENT
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Name | MS. ROBIN NELL DUDASH
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Credential | B.C.O.
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Telephone | 713-524-1001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156FX1700X
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Taxonomy Name | Ocularist
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License Number |
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License Number State |
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