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General NPI Number Information
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NPI Number | 1255308532
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Entity Type | Individual
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Provider Name | PAUL ANTHONY PROSKE O.D.
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Gender | Male
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Dates
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Enumeration Date | 03/04/2006
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Last Update Date | 02/09/2010
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Provider Practice Location Address
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Address Line | 20920 KUYKENDAHL RD STE C
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City | SPRING
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State | TX
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Zip | 77379-3378
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Country | US
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Telephone | 281-353-3937
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Fax | 281-528-9451
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Provider Business Mailing Address
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Address Line | 17428 KITZMAN RD
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City | CYPRESS
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State | TX
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Zip | 77429-1294
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Country | US
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Telephone | 281-351-0555
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 05881TG
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License Number State | TX
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