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General NPI Number Information
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NPI Number | 1598059446
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Entity Type | Organization
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Legal Business Name | CRYSTAL KLEAR OPTICAL
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Dates
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Enumeration Date | 06/07/2011
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 14360 BELLAIRE BLVD STE 132
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City | HOUSTON
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State | TX
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Zip | 77083-7516
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Country | US
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Telephone | 281-564-6400
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Fax | 281-564-6450
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Provider Business Mailing Address
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Address Line | 14360 BELLAIRE BLVD STE 132
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City | HOUSTON
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State | TX
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Zip | 77083-7516
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Country | US
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Telephone | 281-564-6400
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Fax | 281-564-6450
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Authorized Official
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Title or Position | OWNER
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Name | PEARL C OGUCHI
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Credential |
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Telephone | 281-564-6400
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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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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 069591
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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