MEDICARE: RJ CASSIDY OPTICIANS, INC.

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	332H00000X	Eyewear Supplier		TX

General Provider Information

NPI Number	:	1962860668
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RJ CASSIDY OPTICIANS, INC.

Provider Business Mailing Address
First Line	:	2900 WESTHEIMER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1112
Country	:	US
Telephone Number	:	713-523-8682
Fax Number	:	713-528-1207

Provider Business Practice Location Address
First Line	:	2900 WESTHEIMER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1112
Country	:	US
Telephone Number	:	713-523-8682
Fax Number	:	713-528-1207

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. KIM A FLEEMAN
Credential	:	OPTICIAN
Telephone Number	:	713-523-8682

Provider Enumeration Date	:	02/09/2016
Last Update Date	:	07/21/2022

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