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General NPI Number Information
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NPI Number | 1861997652
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Entity Type | Organization
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Legal Business Name | LAUREN EYE GROUP LLC
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 08/30/2018
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Provider Practice Location Address
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Address Line | 5135 W ALABAMA ST STE 5410
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City | HOUSTON
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State | TX
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Zip | 77056
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Country | US
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Telephone | 713-963-0021
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Fax |
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Provider Business Mailing Address
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Address Line | 5135 W ALABAMA ST STE 5410
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City | HOUSTON
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State | TX
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Zip | 77056-5814
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Country | US
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Telephone | 713-963-0021
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING COORD
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Name | JIMMY PRICE
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Credential |
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Telephone | 832-277-6870
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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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