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General NPI Number Information
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NPI Number | 1912081647
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Entity Type | Organization
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Legal Business Name | LTW VISION EMPIRE, P.A.
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/10/2010
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Provider Practice Location Address
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Address Line | 22762 WESTHEIMER PKWY STE 405
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City | KATY
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State | TX
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Zip | 77450-8825
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Country | US
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Telephone | 281-395-2010
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Fax |
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Provider Business Mailing Address
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Address Line | 4406 EDEN POINT LN
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City | KATY
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State | TX
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Zip | 77494-6469
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Country | US
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Telephone | 713-240-4069
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. LAURENCE C WONG
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Credential | O.D.
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Telephone | 713-240-4069
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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 | 6270TG
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License Number State | TX
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