Provider Demographics
NPI:1861997652
Name:LAUREN EYE GROUP LLC
Entity type:Organization
Organization Name:LAUREN EYE GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORD
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-277-6870
Mailing Address - Street 1:5135 W ALABAMA ST STE 5410
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-5814
Mailing Address - Country:US
Mailing Address - Phone:713-963-0021
Mailing Address - Fax:
Practice Address - Street 1:5135 W ALABAMA ST STE 5410
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056
Practice Address - Country:US
Practice Address - Phone:713-963-0021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EBF EYE PRO, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-26
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty