MEDICARE: EYE CLINIC OF HOUSTON INC

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	580	MS

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	:	1548314818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE CLINIC OF HOUSTON INC

Provider Business Mailing Address
First Line	:	812 N JACKSON ST
Second Line	:
City	:	HOUSTON
State	:	MS
Zip	:	38851-1203
Country	:	US
Telephone Number	:	662-456-2020
Fax Number	:	662-456-3494

Provider Business Practice Location Address
First Line	:	812 N JACKSON ST
Second Line	:
City	:	HOUSTON
State	:	MS
Zip	:	38851-1203
Country	:	US
Telephone Number	:	662-456-2020
Fax Number	:	662-456-3494

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GEORGE A POWELL
Credential	:	O.D.
Telephone Number	:	662-456-2020

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	12/03/2025

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Directions to “EYE CLINIC OF HOUSTON INC ” Practice Location

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