=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255716528
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SPRING FAMILY EYECARE, P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2015
-----------------------------------------------------
Last Update Date | 07/28/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 155 LOUETTA XING
-----------------------------------------------------
City | SPRING
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77373-3007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-350-9992
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17117 WESTHEIMER RD # 25
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77082-1259
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-350-9992
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT
-----------------------------------------------------
Name | ANH-HONG UNGER
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 713-412-5545
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 5336TG
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------