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General NPI Number Information
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NPI Number | 1902996358
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Entity Type | Organization
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Legal Business Name | SANDRA SHINA HOU OD PC
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Dates
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Enumeration Date | 10/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2001 W MAPLE RD WAL-MART VISION CENTER
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City | TROY
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State | MI
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Zip | 48084-7100
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Country | US
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Telephone | 248-435-4126
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Fax | 248-435-4162
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Provider Business Mailing Address
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Address Line | 2059 CATTAIL CIRCLE
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-3820
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Country | US
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Telephone | 248-852-0445
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Fax | 248-852-0445
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Authorized Official
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Title or Position | PRESIDENT
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Name | SANDRA SHINA HOU
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Credential | OD
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Telephone | 248-852-0445
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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 | 4901004170
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License Number State | MI
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