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General NPI Number Information
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NPI Number | 1538526173
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Entity Type | Organization
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Legal Business Name | MACULA VITREOUS RETINA PHYSICIANS & SURGEONS PA
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Dates
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Enumeration Date | 01/27/2016
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 6655 TRAVIS ST SUITE 560
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City | HOUSTON
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State | TX
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Zip | 77030-1312
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Country | US
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Telephone | 713-637-4408
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Fax | 832-547-2221
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Provider Business Mailing Address
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Address Line | 6655 TRAVIS ST STE 560
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City | HOUSTON
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State | TX
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Zip | 77030-1316
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Country | US
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Telephone | 713-637-4408
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Fax | 346-226-3668
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Authorized Official
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Title or Position | PRESIDENT
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Name | PETROS EUTHYMIOU CARVOUNIS
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Credential | MD
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Telephone | 713-637-4408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | M1566
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License Number State | TX
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