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General NPI Number Information
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NPI Number | 1427734565
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Entity Type | Organization
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Legal Business Name | SHELBY DEBNAM VISION
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Dates
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Enumeration Date | 06/23/2023
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 841 YALE SECOND FLOOR
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City | HOUSTON
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State | TX
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Zip | 77007-1612
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Country | US
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Telephone | 832-302-4648
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Fax |
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Provider Business Mailing Address
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Address Line | 841 YALE SECOND FLOOR
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City | HOUSTON
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State | TX
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Zip | 77007-1612
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Country | US
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Telephone | 832-302-4648
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PATIENT CARE
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Name | MS. CAROL ANNE PEQUET
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Credential |
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Telephone | 832-302-4648
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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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