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General NPI Number Information
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NPI Number | 1841715141
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Entity Type | Organization
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Legal Business Name | HEA SUB ONE. PLLC
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Dates
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Enumeration Date | 08/08/2017
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Last Update Date | 08/08/2017
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Provider Practice Location Address
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Address Line | 2855 GRAMERCY ST
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City | HOUSTON
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State | TX
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Zip | 77025-1756
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Country | US
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Telephone | 713-668-6828
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Fax |
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Provider Business Mailing Address
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Address Line | 7155 OLD KATY RD STE N100
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City | HOUSTON
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State | TX
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Zip | 77024-2270
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE ADMINISTRATOR
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Name | RICHARD CANADY
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Credential |
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Telephone | 713-668-6828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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