Provider Demographics
NPI:1003334699
Name:CHOI, HAESOUL (OD)
Entity Type:Individual
Prefix:DR
First Name:HAESOUL
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25138 FLORINA RANCH DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-0468
Mailing Address - Country:US
Mailing Address - Phone:210-216-3052
Mailing Address - Fax:
Practice Address - Street 1:12548 WESTHEIMER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-5808
Practice Address - Country:US
Practice Address - Phone:281-249-8380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-02
Last Update Date:2017-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9227152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist