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General NPI Number Information
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NPI Number | 1780921189
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Entity Type | Organization
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Legal Business Name | MINH QUACH LLC
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Dates
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Enumeration Date | 01/07/2013
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Last Update Date | 11/09/2018
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Provider Practice Location Address
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Address Line | 3045 SILVERLAKE VILLAGE DR
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City | PEARLAND
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State | TX
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Zip | 77584-8080
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Country | US
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Telephone | 713-436-0777
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Fax | 281-612-0111
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Provider Business Mailing Address
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Address Line | 1315 W HUNTERS COURT DR
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City | HOUSTON
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State | TX
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Zip | 77055-6872
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Country | US
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Telephone | 713-436-0777
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Fax | 281-612-0111
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | MINH QUACH
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Credential | OD
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Telephone | 713-436-0777
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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 | 7344TG
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License Number State | TX
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