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General NPI Number Information
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NPI Number | 1073654794
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Entity Type | Organization
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Legal Business Name | THE LASIK VISION INSTITUTE LLC
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 11/16/2011
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Provider Practice Location Address
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Address Line | 1800 BERING DR STE 200
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City | HOUSTON
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State | TX
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Zip | 77057-3151
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Country | US
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Telephone | 713-490-0880
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 PALM BEACH LAKES BLVD STE 800
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-6503
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Country | US
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Telephone | 561-965-9110
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Fax | 706-243-4627
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Authorized Official
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Title or Position | COO
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Name | MR. BEN COOK
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Credential |
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Telephone | 561-965-9110
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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 |
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License Number State |
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