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General NPI Number Information
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NPI Number | 1730613076
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Entity Type | Organization
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Legal Business Name | DECORDOVA EYEWEAR LLC
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Dates
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Enumeration Date | 04/13/2017
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 12230 WEST LAKE HOUSTON PARKWAY SUITE 155
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City | HUMBLE
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State | TX
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Zip | 77044
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Country | US
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Telephone | 281-763-2006
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Fax |
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Provider Business Mailing Address
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Address Line | 27390 PENDLETON TRACE DR
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City | SPRING
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State | TX
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Zip | 77386-4267
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Country | US
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Telephone | 281-630-7994
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KERR-ANN COOMBS
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Credential | OD
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Telephone | 281-763-2006
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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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