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General NPI Number Information
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NPI Number | 1649371782
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Entity Type | Organization
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Legal Business Name | TODAY'S VISION - DEERBROOK, P.C.
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 05/18/2010
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Provider Practice Location Address
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Address Line | 20811 HIGHWAY 59 N STE 300
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City | HUMBLE
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State | TX
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Zip | 77338-2260
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Country | US
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Telephone | 281-446-2020
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Fax | 281-548-3411
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Provider Business Mailing Address
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Address Line | 20811 HIGHWAY 59 N STE 300
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City | HUMBLE
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State | TX
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Zip | 77338-2260
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Country | US
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Telephone | 281-446-2020
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Fax | 281-548-3411
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Authorized Official
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Title or Position | OWNER / PRESIDENT
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Name | DR. JAY PRAVDA
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Credential | O.D.
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Telephone | 281-446-2020
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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 | 2295T
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License Number State | TX
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