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General NPI Number Information
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NPI Number | 1629081799
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Entity Type | Organization
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Legal Business Name | MANN EYE CENTER, PA
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 5115 FANNIN ST STE 1000
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City | HOUSTON
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State | TX
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Zip | 77004-5805
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Country | US
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Telephone | 713-580-2500
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Fax | 713-580-2597
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Provider Business Mailing Address
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Address Line | PO BOX 4346 DEPT 368
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City | HOUSTON
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State | TX
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Zip | 77210-4346
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Country | US
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Telephone | 713-275-2461
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Fax | 713-275-2496
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | JILL ROSALES
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Credential |
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Telephone | 713-275-2457
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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