Provider Demographics
NPI:1528330677
Name:PEDIATRIC OPHTHALMOLOGY OF HOUSTON PA
Entity type:Organization
Organization Name:PEDIATRIC OPHTHALMOLOGY OF HOUSTON PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:SYLVIA
Authorized Official - Last Name:HASSMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-467-4448
Mailing Address - Street 1:929 GESSNER RD
Mailing Address - Street 2:# 2420
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2515
Mailing Address - Country:US
Mailing Address - Phone:713-467-4448
Mailing Address - Fax:713-467-3041
Practice Address - Street 1:929 GESSNER RD
Practice Address - Street 2:# 2420
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2515
Practice Address - Country:US
Practice Address - Phone:713-467-4448
Practice Address - Fax:713-467-3041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00NK16Medicare PIN