Provider Demographics
NPI:1154458966
Name:TEXAS EYE PHYSICIANS PA
Entity Type:Organization
Organization Name:TEXAS EYE PHYSICIANS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HUY
Authorized Official - Middle Name:M
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-861-3937
Mailing Address - Street 1:PO BOX 202363
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-8363
Mailing Address - Country:US
Mailing Address - Phone:817-861-3937
Mailing Address - Fax:817-861-3914
Practice Address - Street 1:101 W RANDOL MILL RD
Practice Address - Street 2:STE 120
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-4637
Practice Address - Country:US
Practice Address - Phone:817-861-3937
Practice Address - Fax:817-861-3914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2382207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156738001Medicaid
TX156738001Medicaid