MEDICARE: EYECARE FOR YOU PC

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	6613	TX

General Provider Information

NPI Number	:	1699965855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYECARE FOR YOU PC

Provider Business Mailing Address
First Line	:	13433 TOMBALL PKWY
Second Line	:	SUITE 9
City	:	HOUSTON
State	:	TX
Zip	:	77086-3169
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13433 TOMBALL PKWY
Second Line	:	SUITE 9
City	:	HOUSTON
State	:	TX
Zip	:	77086-3169
Country	:	US
Telephone Number	:	281-272-2555
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	TU PHAM
Credential	:
Telephone Number	:	281-272-2555

Provider Enumeration Date	:	07/25/2007
Last Update Date	:	07/11/2012

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