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General NPI Number Information
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NPI Number | 1093992752
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Entity Type | Organization
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Legal Business Name | BAYBROOK VISION CENTER INC
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Dates
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Enumeration Date | 01/24/2008
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 1520 W BAY AREA BLVD SUITE 1
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-2600
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Country | US
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Telephone | 281-488-7033
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Fax | 281-488-4423
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Provider Business Mailing Address
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Address Line | 1520 W BAY AREA BLVD SUITE 1
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-2600
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Country | US
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Telephone | 281-488-7033
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Fax | 281-488-4423
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAN G. TOM
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Credential | O.D.
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Telephone | 281-488-7033
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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 | 03230TG
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License Number State | TX
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