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General NPI Number Information
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NPI Number | 1548364250
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Entity Type | Organization
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Legal Business Name | HARRISBURG EYE CLINIC PA
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 08/15/2008
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Provider Practice Location Address
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Address Line | 7430 HARRISBURG BLVD
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City | HOUSTON
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State | TX
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Zip | 77011-4741
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Country | US
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Telephone | 713-928-2796
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Fax | 713-928-5082
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Provider Business Mailing Address
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Address Line | 7438 HARRISBURG BLVD
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City | HOUSTON
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State | TX
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Zip | 77011-4741
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Country | US
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Telephone | 713-928-3375
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Fax | 713-928-6173
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL EDWARDS JENKINS III
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Credential | M.D.
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Telephone | 713-928-3375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | DR0223
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License Number State | TX
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