MEDICARE: MR. STEVEN GINSBERG OPTICIAN

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	156FX1800X	Optician	DR0771	TX

General Provider Information

NPI Number	:	1407077886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVEN GINSBERG OPTICIAN

Provider Business Mailing Address
First Line	:	2421 W HOLCOMBE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1901
Country	:	US
Telephone Number	:	713-668-2885
Fax Number	:	713-668-3373

Provider Business Practice Location Address
First Line	:	2421 W HOLCOMBE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1901
Country	:	US
Telephone Number	:	713-668-2885
Fax Number	:	713-668-3373

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	07/08/2007

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