MEDICARE: OPTICS EYECARE PLLC

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	8163TG	TX

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	:	1316365273
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTICS EYECARE PLLC

Provider Business Mailing Address
First Line	:	12343 MAIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77035-6205
Country	:	US
Telephone Number	:	713-597-2020
Fax Number	:	281-990-6841

Provider Business Practice Location Address
First Line	:	12343 MAIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77035-6205
Country	:	US
Telephone Number	:	713-597-2020
Fax Number	:	281-990-6841

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	ANITA ALI
Credential	:	O.D.
Telephone Number	:	713-371-6443

Provider Enumeration Date	:	03/28/2014
Last Update Date	:	05/09/2016

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