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General NPI Number Information
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NPI Number | 1932773264
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Entity Type | Organization
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Legal Business Name | SMJ EYE GROUP PLLC
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Dates
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Enumeration Date | 05/20/2021
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Last Update Date | 12/16/2021
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Provider Practice Location Address
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Address Line | 9453 KATY FWY STE B
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City | HOUSTON
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State | TX
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Zip | 77024-1503
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Country | US
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Telephone | 346-395-5563
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 79124
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City | HOUSTON
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State | TX
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Zip | 77279-9124
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Country | US
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Telephone | 281-300-1447
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JITESH PATEL
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Credential | OD
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Telephone | 281-300-1447
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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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