MEDICARE: DR. THOMAS GEOFFREY ISZARD 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	4099-TG	TX

General Provider Information

NPI Number	:	1871625103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS GEOFFREY ISZARD O.D.

Provider Business Mailing Address
First Line	:	1315 ST JOSEPH PKWY STE 150
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-8233
Country	:	US
Telephone Number	:	713-659-3937
Fax Number	:	713-337-6801

Provider Business Practice Location Address
First Line	:	1315 ST JOSEPH PKWY STE 1205
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-8235
Country	:	US
Telephone Number	:	713-659-3937
Fax Number	:	713-337-6801

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

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	05/20/2015

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