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General NPI Number Information
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NPI Number | 1407980725
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Entity Type | Organization
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Legal Business Name | COASTAL EYE ASSOCIATES, PLLC
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 1913 STEELE RD
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City | ALVIN
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State | TX
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Zip | 77511
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Country | US
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Telephone | 281-488-7213
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Fax | 281-824-8711
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Provider Business Mailing Address
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Address Line | 555 E MEDICAL CENTER BLVD SUITE 101
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City | WEBSTER
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State | TX
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Zip | 77598
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Country | US
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Telephone | 281-488-7213
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Fax | 281-488-1387
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Authorized Official
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Title or Position | EXECUTIVE ADMINISTRATOR
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Name | MR. KELLY FERREE
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Credential |
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Telephone | 281-488-7213
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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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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | TX
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