Provider Demographics
NPI:1275246530
Name:LAUREN & ALEX EYE PRO LLC
Entity Type:Organization
Organization Name:LAUREN & ALEX EYE PRO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMIL
Authorized Official - Middle Name:B
Authorized Official - Last Name:FADEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-345-5642
Mailing Address - Street 1:3315 CHARTREUSE WAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-6857
Mailing Address - Country:US
Mailing Address - Phone:956-655-0008
Mailing Address - Fax:
Practice Address - Street 1:4909 GATTIS SCHOOL ROAD
Practice Address - Street 2:105
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634
Practice Address - Country:US
Practice Address - Phone:512-617-3255
Practice Address - Fax:512-617-3245
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAUREN AND ALEX EYE PRO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty