Provider Demographics
NPI:1124596218
Name:EXCEPTIONAL EYE CARE CONSULTANTS INC
Entity Type:Organization
Organization Name:EXCEPTIONAL EYE CARE CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:OHAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-342-4664
Mailing Address - Street 1:4000 AVENUE I
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-3904
Mailing Address - Country:US
Mailing Address - Phone:281-342-4664
Mailing Address - Fax:281-232-0894
Practice Address - Street 1:4000 AVENUE I
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-3904
Practice Address - Country:US
Practice Address - Phone:281-342-4664
Practice Address - Fax:281-232-0894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-06
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty