=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295911345
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LIFETIME EYECARE ASSOCIATES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/18/2008
-----------------------------------------------------
Last Update Date | 10/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8765 SPRING CYPRESS RD STE N
-----------------------------------------------------
City | SPRING
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77379-3195
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-655-9595
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8765 SPRING CYPRESS RD STE N
-----------------------------------------------------
City | SPRING
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77379-3195
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-655-9595
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER DOCTOR
-----------------------------------------------------
Name | GRISEL LAGUNAS
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 281-465-8300
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 6168T
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------