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General NPI Number Information
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NPI Number | 1689710196
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Entity Type | Organization
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Legal Business Name | MODERNEYES VISION CENTER
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 11/03/2007
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Provider Practice Location Address
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Address Line | 4603 FM 1960 RD W # C
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City | HOUSTON
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State | TX
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Zip | 77069-4603
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Country | US
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Telephone | 281-893-1233
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Fax | 281-893-1232
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Provider Business Mailing Address
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Address Line | 4603 FM 1960 RD W # C
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City | HOUSTON
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State | TX
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Zip | 77069-4603
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Country | US
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Telephone | 281-893-1233
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Fax | 281-893-1232
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALICE CHOY
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Credential | O.D.
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Telephone | 281-893-1233
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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 | 4823TG
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5718T
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License Number State | TX
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