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General NPI Number Information
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NPI Number | 1508934738
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Entity Type | Organization
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Legal Business Name | BELLAIRE FAMILY EYE CARE PA
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 09/23/2008
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Provider Practice Location Address
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Address Line | 5001 BISSONNET SUITE 107
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City | BELLAIRE
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State | TX
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Zip | 77401
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Country | US
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Telephone | 713-664-8087
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Fax | 713-664-8078
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Provider Business Mailing Address
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Address Line | 5001 BISSONNET SUITE 107
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City | BELLAIRE
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State | TX
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Zip | 77401
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Country | US
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Telephone | 713-664-8087
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Fax | 713-664-8078
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Authorized Official
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Title or Position | INSURANCE CLERK
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Name | MRS. LAURI J STOLL
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Credential |
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Telephone | 713-664-8087
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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 | 4164TG
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License Number State | TX
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