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NPI Code Detail

MEDICARE: IMG EYECARE PLLC

MEDICARE: IMG EYECARE PLLC
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
1152W00000XOptometrist8319TX

General Provider Information

NPI Number : 1740665801
Entity Type Code : Organization
Provider Name (Legal Business Name) : IMG EYECARE PLLC
Provider Business Mailing Address
First Line : 5405 S RICE AVE
Second Line :
City : HOUSTON
State : TX
Zip : 77081-2113
Country : US
Telephone Number : 713-955-2015
Fax Number :
Provider Business Practice Location Address
First Line : 5405 S RICE AVE
Second Line :
City : HOUSTON
State : TX
Zip : 77081-2113
Country : US
Telephone Number : 713-955-2015
Fax Number :
Authorized Official
Title or Position : OWNER
Name : TRI NGUYEN
Credential :
Telephone Number : 713-955-2015
Provider Enumeration Date : 07/29/2015
Last Update Date : 09/21/2015

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