MEDICARE: PREFERRED EYE CARE PROFESSIONAL CORP

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

General Provider Information

NPI Number	:	1518764331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED EYE CARE PROFESSIONAL CORP

Provider Business Mailing Address
First Line	:	4515 COUNTRYMEADOWS DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-2553
Country	:	US
Telephone Number	:	832-244-1491
Fax Number	:

Provider Business Practice Location Address
First Line	:	2454 CYPRESS CREEK PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77068-3720
Country	:	US
Telephone Number	:	281-537-2020
Fax Number	:

Authorized Official
Title or Position	:	OWNER / THERAPEUTIC OPTOMETRIST
Name	:	HASEEB BACCHUS
Credential	:	O.D.
Telephone Number	:	832-244-1491

Provider Enumeration Date	:	02/27/2025
Last Update Date	:	02/27/2025

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