MEDICARE: MOMIN VISION CARE 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	:	1881191435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOMIN VISION CARE PA

Provider Business Mailing Address
First Line	:	6144 SIENNA RANCH RD STE 600
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-7404
Country	:	US
Telephone Number	:	832-945-5400
Fax Number	:	844-274-0503

Provider Business Practice Location Address
First Line	:	6144 SIENNA RANCH RD STE 600
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-7404
Country	:	US
Telephone Number	:	832-945-5400
Fax Number	:	844-274-0503

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. IMRANA ISMAIL MOMIN
Credential	:	OD
Telephone Number	:	832-945-5400

Provider Enumeration Date	:	04/10/2018
Last Update Date	:	07/01/2019

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