Provider Demographics
NPI:1427220524
Name:PEDIATRIC OPHTHALMOLOGY OF HOUSTON
Entity Type:Organization
Organization Name:PEDIATRIC OPHTHALMOLOGY OF HOUSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MONTE
Authorized Official - Middle Name:I
Authorized Official - Last Name:STAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-467-4448
Mailing Address - Street 1:909 FROSTWOOD SUITE 334
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024
Mailing Address - Country:US
Mailing Address - Phone:713-467-4448
Mailing Address - Fax:713-467-3041
Practice Address - Street 1:909 FROSTWOOD SUITE 334
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024
Practice Address - Country:US
Practice Address - Phone:713-467-4448
Practice Address - Fax:713-467-3041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty