Basic Information
| Provider Information | |||||||||
| NPI: | 1568885010 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FAMILY EYE HEALTH SOLUTIONS PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5201 HIGHWAY 6 STE 700 | ||||||||
| Address2: | |||||||||
| City: | MISSOURI CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774594379 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154799112 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5201 HIGHWAY 6 STE 700 | ||||||||
| Address2: | |||||||||
| City: | MISSOURI CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774594379 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154799112 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2014 | ||||||||
| LastUpdateDate: | 02/03/2014 | ||||||||
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| AuthorizedOfficialLastName: | JOSEPH | ||||||||
| AuthorizedOfficialFirstName: | JIMMY | ||||||||
| AuthorizedOfficialMiddleName: | V | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2154799112 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | OD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.