MEDICARE: SURGICAL EYE ASSOCIATES, P.A.

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	05253T	TX
2	152W00000X	Optometrist	03629TG	TX
3	207W00000X	Ophthalmology Physician	G2587	TX
4	207W00000X	Ophthalmology Physician	F0436	TX

General Provider Information

NPI Number	:	1992922777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURGICAL EYE ASSOCIATES, P.A.

Provider Business Mailing Address
First Line	:	1631 NORTH LOOP WEST
Second Line	:	SUITE 500
City	:	HOUSTON
State	:	TX
Zip	:	77008
Country	:	US
Telephone Number	:	713-869-6400
Fax Number	:	713-802-0691

Provider Business Practice Location Address
First Line	:	829 PEAKWOOD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-2907
Country	:	US
Telephone Number	:	281-537-0100
Fax Number	:	281-537-5093

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PETER SUTHERLAND DAWSON
Credential	:	M.D.
Telephone Number	:	281-537-0100

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	10/03/2007

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