Provider Demographics
NPI:1164692232
Name:A AT T EYECARE, PROFRESSSIONAL ASSOCIATION
Entity Type:Organization
Organization Name:A AT T EYECARE, PROFRESSSIONAL ASSOCIATION
Other - Org Name:A@T EYECARE, P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-530-3331
Mailing Address - Street 1:11169 BEECHNUT STREET
Mailing Address - Street 2:SUITE H
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-4341
Mailing Address - Country:US
Mailing Address - Phone:281-530-3331
Mailing Address - Fax:281-530-3331
Practice Address - Street 1:11169 BEECHNUT ST
Practice Address - Street 2:SUITE H
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-4340
Practice Address - Country:US
Practice Address - Phone:281-530-3331
Practice Address - Fax:281-530-3331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6321TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173407101Medicaid
TX173407101Medicaid
TXU92548Medicare UPIN
TX00616YMedicare PIN