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General NPI Number Information
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NPI Number | 1043512635
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Entity Type | Organization
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Legal Business Name | MEMORIAL PARK VISION, P.A.
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Dates
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Enumeration Date | 12/02/2010
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Last Update Date | 12/02/2010
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Provider Practice Location Address
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Address Line | 5535 MEMORIAL DR SUITE I
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City | HOUSTON
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State | TX
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Zip | 77007-8021
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Country | US
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Telephone | 281-888-9256
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Fax | 281-501-2814
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Provider Business Mailing Address
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Address Line | 5535 MEMORIAL DR SUITE I
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City | HOUSTON
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State | TX
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Zip | 77007-8021
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Country | US
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Telephone | 281-888-9256
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Fax | 281-501-2814
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Authorized Official
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Title or Position | OPTOMETRIST/ CEO
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Name | DR. DANA HOWARD
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Credential | O.D.
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Telephone | 281-888-9256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7272TG
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License Number State | TX
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