Provider Demographics
NPI:1275554214
Name:EXQUISITE EYE CARE PA
Entity Type:Organization
Organization Name:EXQUISITE EYE CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OD
Authorized Official - Prefix:
Authorized Official - First Name:ANATONY
Authorized Official - Middle Name:NHU
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-580-3937
Mailing Address - Street 1:11509 VETERANS MEMORIAL DR
Mailing Address - Street 2:SUITE 900
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067
Mailing Address - Country:US
Mailing Address - Phone:281-580-3937
Mailing Address - Fax:281-580-3933
Practice Address - Street 1:11509 VETERANS MEMORIAL DR
Practice Address - Street 2:SUITE 900
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067
Practice Address - Country:US
Practice Address - Phone:281-580-3937
Practice Address - Fax:281-580-3933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6604TG152W00000X
TX6623TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00464XMedicare ID - Type Unspecified