Brazosport Professional Eye Clinic Inc in Lake Jackson - Optometrist
Brazosport Professional Eye Clinic Inc - NPI 1073607370
Brazosport Professional Eye Clinic Inc is a Optometrist in Lake Jackson, Texas. Brazosport Professional Eye Clinic Inc practices all healthcare services and medical treatments related to Optometrist. The NPI Number for Brazosport Professional Eye Clinic Inc is 1073607370. The last update date is 2008-12-11.
Brazosport Professional Eye Clinic Inc's current location address is 123 Circle Way, Lake Jackson, Texas. You can contact this provider via phone number 9792993250 and fax number 9792991724. The mailing address for Brazosport Professional Eye Clinic Inc is 123 Circle Way, Lake Jackson, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Brazosport Professional Eye Clinic Inc |
|---|---|
| Address | 123 Circle Way, Lake Jackson, Texas |
| Phone Number | 9792993250 |
| Fax Number | 9792991724 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Provenzano Allen Mark |
| Credentials | OD |
| Telephone Number | 9792993250 |
NPI Number Detail
| NPI Number | 1073607370 |
|---|---|
| Provider Enumeration Date | 2006-10-03 |
| Last Updated Date | 2008-12-11 |
Provider Mailing Address Detail
| Address | 123 Circle Way |
|---|---|
| City | Lake Jackson |
| State | Texas (TX) |
| Post Code | 775665233 |
| Phone Number | 9792993250 |
| Fax Number | 9792991724 |
Provider's Primary Taxonomy Detail
| Speciality | Optometrist |
|---|---|
| Taxonomy | 152W00000X |
| Licence No | 3979TG |
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Definition: Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 195042 | TX | -- | |
| 80775Q | TX | BCBS OF TX |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Brazosport Professional Eye Clinic Inc by the Centers for Medicare & Medicaid Services?
The Brazosport Professional Eye Clinic Inc has been issued the NPI (National Provider Identifier) 1073607370, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Brazosport Professional Eye Clinic Inc?
The Brazosport Professional Eye Clinic Inc is physically situated at 123 Circle Way, in the city of Lake Jackson, state of TX, with the postal code 775665233.
What is Brazosport Professional Eye Clinic Inc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Brazosport Professional Eye Clinic Inc's area of specialization is Optometrist, and the corresponding taxonomy code that categorizes this field of practice is 152W00000X.
On what date did the Brazosport Professional Eye Clinic Inc receive the assignment of its 1073607370 from the Centers for Medicare & Medicaid Services?
The Brazosport Professional Eye Clinic Inc was issued its 1073607370 by the Centers for Medicare & Medicaid Services on 2006-10-03.
When was the information regarding Brazosport Professional Eye Clinic Inc most recently updated?
The details pertaining to the Brazosport Professional Eye Clinic Inc, including its address, specialty, and other relevant information, were last refreshed on 2008-12-11.
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