Provider Demographics
NPI:1902342124
Name:ELDRIDGE EYE CARE PA
Entity Type:Organization
Organization Name:ELDRIDGE EYE CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALINAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:OD/OWNER
Authorized Official - Phone:832-934-1166
Mailing Address - Street 1:1022 WELDON PARK DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3530
Mailing Address - Country:US
Mailing Address - Phone:832-934-1166
Mailing Address - Fax:832-934-1161
Practice Address - Street 1:1022 WELDON PARK DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3530
Practice Address - Country:US
Practice Address - Phone:832-934-1166
Practice Address - Fax:832-934-1161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty