Basic Information
| Provider Information | |||||||||
| NPI: | 1467419903 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARKUS | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 505 J DAVIS ARMISTEAD BLDG | ||||||||
| Address2: | 4901 CLAHOUN | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 772042020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137432020 | ||||||||
| FaxNumber: | 7137430963 | ||||||||
| Practice Location | |||||||||
| Address1: | 505 J DAVIS ARMISTEAD BLDG | ||||||||
| Address2: | 4901 CLAHOUN | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 772042020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137432020 | ||||||||
| FaxNumber: | 7137430963 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2006 | ||||||||
| LastUpdateDate: | 07/12/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 4998TG | TX | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 1548224-10 | 05 | TX | MEDICAID |