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General NPI Number Information
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NPI Number | 1407143076
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Entity Type | Organization
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Legal Business Name | WESTSIDE EYE CARE
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Dates
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Enumeration Date | 07/05/2011
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 1560 ELDRIDGE PKWY SUITE 136
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City | HOUSTON
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State | TX
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Zip | 77077-1761
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Country | US
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Telephone | 281-235-5443
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8176
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City | HOUSTON
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State | TX
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Zip | 77288-8176
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Country | US
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Telephone | 281-235-5443
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THAO THIEN NGUYEN
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Credential | O.D.
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Telephone | 281-235-5442
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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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