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General NPI Number Information
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NPI Number | 1477912202
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Entity Type | Organization
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Legal Business Name | SUNRISE VISA LLC
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Dates
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Enumeration Date | 02/22/2016
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Last Update Date | 02/22/2016
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Provider Practice Location Address
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Address Line | 1537 W BAY AREA BLVD
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City | WEBSTER
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State | TX
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Zip | 77598-3400
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Country | US
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Telephone | 281-954-3655
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Fax | 281-954-3658
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Provider Business Mailing Address
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Address Line | 18850 S MEMORIAL DR
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City | HUMBLE
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State | TX
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Zip | 77338-4288
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Country | US
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Telephone | 281-446-7900
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING COORD
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Name | JIMMY PRICE
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Credential |
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Telephone | 713-275-2457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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