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General NPI Number Information
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NPI Number | 1417195330
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Entity Type | Organization
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Legal Business Name | JULIE K. LY, OD AND ASSOCIATES
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Dates
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Enumeration Date | 01/30/2009
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 24502 KINGSLAND BLVD
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City | KATY
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State | TX
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Zip | 77494-3429
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Country | US
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Telephone | 281-394-5006
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Fax | 281-589-0999
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Provider Business Mailing Address
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Address Line | 24502 KINGSLAND BLVD
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City | KATY
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State | TX
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Zip | 77494-3429
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Country | US
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Telephone | 281-589-4263
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Fax | 281-589-0999
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | JULIE K LY
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Credential | OD
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Telephone | 281-394-5006
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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 | 6900TG
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License Number State | TX
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