MEDICARE: MY HEALTH SIGHT

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	261QG0250X	Genetics Clinic/Center
2	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1225594559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY HEALTH SIGHT

Provider Business Mailing Address
First Line	:	10101 FONDREN RD STE 112
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77096-4679
Country	:	US
Telephone Number	:	409-753-5679
Fax Number	:

Provider Business Practice Location Address
First Line	:	10101 FONDREN RD STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77096-4558
Country	:	US
Telephone Number	:	832-599-5812
Fax Number	:

Authorized Official
Title or Position	:	NEW BIZ DEV
Name	:	EFRAIM MEIR MANDEL
Credential	:
Telephone Number	:	409-753-5679

Provider Enumeration Date	:	02/12/2019
Last Update Date	:	12/26/2021

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Directions to “MY HEALTH SIGHT ” Practice Location

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