MEDICARE: BEECHNUT EYE DOCS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134200546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEECHNUT EYE DOCS PC

Provider Business Mailing Address
First Line	:	8300 W SAM HOUSTON PKWY S
Second Line	:	STE 248
City	:	HOUSTON
State	:	TX
Zip	:	77072-5045
Country	:	US
Telephone Number	:	281-568-8787
Fax Number	:	281-568-8786

Provider Business Practice Location Address
First Line	:	8300 W SAM HOUSTON PKWY S
Second Line	:	STE 248
City	:	HOUSTON
State	:	TX
Zip	:	77072-5045
Country	:	US
Telephone Number	:	281-568-8787
Fax Number	:	281-568-8786

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SCHUBERT-THUY NGUYEN
Credential	:	OD
Telephone Number	:	281-568-8787

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	07/26/2009

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Directions to “BEECHNUT EYE DOCS PC ” Practice Location

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