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General NPI Number Information
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NPI Number | 1174234371
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Entity Type | Organization
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Legal Business Name | BRILLIANT EYE DOCTORS PLLC
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Dates
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Enumeration Date | 12/08/2022
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Last Update Date | 12/08/2022
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Provider Practice Location Address
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Address Line | 22225 FM 529 RD STE 104
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City | KATY
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State | TX
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Zip | 77493-5095
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Country | US
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Telephone | 979-695-3937
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Fax |
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Provider Business Mailing Address
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Address Line | 10939 SARAH BLUFF LN
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City | CYPRESS
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State | TX
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Zip | 77433-5275
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Country | US
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Telephone | 713-382-9001
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Fax |
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Authorized Official
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Title or Position | MANAGER/CHAIRMAN
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Name | DR. THUONG LE GIST
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Credential | OD
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Telephone | 979-695-3937
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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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