MEDICARE: CHRISTY OPTICAL 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	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1588865869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTY OPTICAL INC

Provider Business Mailing Address
First Line	:	6624 FANNIN ST
Second Line	:	SUITE 130
City	:	HOUSTON
State	:	TX
Zip	:	77030-2741
Country	:	US
Telephone Number	:	713-795-4862
Fax Number	:	713-795-4866

Provider Business Practice Location Address
First Line	:	6624 FANNIN ST
Second Line	:	SUITE 130
City	:	HOUSTON
State	:	TX
Zip	:	77030-2741
Country	:	US
Telephone Number	:	713-790-1085
Fax Number	:	713-790-1087

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. CHARLES A ORR
Credential	:
Telephone Number	:	713-790-1085

Provider Enumeration Date	:	05/31/2007
Last Update Date	:	03/03/2008

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Directions to “CHRISTY OPTICAL INC ” Practice Location

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