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General NPI Number Information
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NPI Number | 1932688785
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE EYE CARE PLLC
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Dates
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Enumeration Date | 08/13/2018
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Last Update Date | 08/13/2018
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Provider Practice Location Address
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Address Line | 3500 BUSINESS CENTER DR
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City | PEARLAND
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State | TX
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Zip | 77584-1952
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Country | US
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Telephone | 281-707-7016
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Fax | 281-707-7017
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Provider Business Mailing Address
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Address Line | 3130 GRANTS LAKE BLVD UNIT 19818
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City | SUGAR LAND
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State | TX
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Zip | 77496-0964
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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 | OWNER/OPTOMETRIST
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Name | SHALINI DEVLUK
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Credential | OD
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Telephone | 832-760-9087
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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 | 7534TG
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License Number State | TX
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