MEDICARE: DR. ELISSA KAY NORRIS O.D.

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	7441T	TX

General Provider Information

NPI Number	:	1730319971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELISSA KAY NORRIS O.D.

Provider Business Mailing Address
First Line	:	2855 GRAMERCY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-1635
Country	:	US
Telephone Number	:	713-668-6828
Fax Number	:	713-558-8785

Provider Business Practice Location Address
First Line	:	1220 AUGUSTA DR
Second Line	:	100
City	:	HOUSTON
State	:	TX
Zip	:	77057-2261
Country	:	US
Telephone Number	:	713-782-4406
Fax Number	:	713-782-2554

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

Provider Enumeration Date	:	07/22/2009
Last Update Date	:	06/02/2010

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