MEDICARE: TSO RAYFORD PA

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

General Provider Information

NPI Number	:	1760843817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TSO RAYFORD PA

Provider Business Mailing Address
First Line	:	3535 RAYFORD ROAD
Second Line	:	SUITE 500
City	:	SPRING
State	:	TX
Zip	:	77386
Country	:	US
Telephone Number	:	832-810-2020
Fax Number	:	832-644-5312

Provider Business Practice Location Address
First Line	:	3535 RAYFORD ROAD
Second Line	:	SUITE 500
City	:	SPRING
State	:	TX
Zip	:	77386
Country	:	US
Telephone Number	:	832-810-2020
Fax Number	:	832-644-5312

Authorized Official
Title or Position	:	OD/OWNER
Name	:	PHONG Q. PHAM
Credential	:	OD/OWNER
Telephone Number	:	832-810-2020

Provider Enumeration Date	:	03/17/2016
Last Update Date	:	03/17/2016

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Directions to “TSO RAYFORD PA ” Practice Location

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