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General NPI Number Information
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NPI Number | 1770904484
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Entity Type | Organization
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Legal Business Name | R HUTTO OD PLLC
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Dates
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Enumeration Date | 12/23/2013
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Last Update Date | 11/04/2014
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Provider Practice Location Address
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Address Line | 6956 GARTH RD
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City | BAYTOWN
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State | TX
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Zip | 77521-9646
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Country | US
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Telephone | 281-421-1243
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Fax | 281-421-7262
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Provider Business Mailing Address
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Address Line | 6956 GARTH RD
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City | BAYTOWN
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State | TX
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Zip | 77521-9646
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Country | US
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Telephone | 281-421-1243
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Fax | 281-421-7262
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Authorized Official
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Title or Position | OWNER
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Name | MARK ANDERSON
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Credential | OD
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Telephone | 281-421-1243
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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 | 3906TG
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License Number State | TX
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