Provider Demographics
NPI:1235460239
Name:INSIGHT VISION CARE PC
Entity Type:Organization
Organization Name:INSIGHT VISION CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF OPTOMETRY
Authorized Official - Prefix:
Authorized Official - First Name:CHIKE
Authorized Official - Middle Name:R
Authorized Official - Last Name:MORDI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:713-748-5000
Mailing Address - Street 1:4899 GRIGGS RD STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-2855
Mailing Address - Country:US
Mailing Address - Phone:713-748-5000
Mailing Address - Fax:713-748-8707
Practice Address - Street 1:4899 GRIGGS RD STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-2855
Practice Address - Country:US
Practice Address - Phone:713-748-5000
Practice Address - Fax:713-748-8707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-15
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7220TG152W00000X
152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX219305401Medicaid
TX7220TGOtherOPTOMETRY LICENSE NUMBER
TX6628440001Medicare NSC
TX219305401Medicaid