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General NPI Number Information
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NPI Number | 1518136977
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Entity Type | Organization
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Legal Business Name | OPTOM-EYES PA
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Dates
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Enumeration Date | 02/29/2008
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 1848 FM 359 ROAD
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City | RICHMOND
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State | TX
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Zip | 77406
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Country | US
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Telephone | 281-232-8257
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Fax | 281-232-9183
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Provider Business Mailing Address
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Address Line | 1848 FM 359 ROAD
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City | RICHMOND
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State | TX
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Zip | 77406
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Country | US
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Telephone | 281-232-8257
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Fax | 281-232-9183
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Authorized Official
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Title or Position | OWNER
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Name | ROSA PHAM NGUYEN
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Credential | O.D.
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Telephone | 281-232-8257
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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 | 5922TG
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License Number State | TX
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